Attachment 4 - Past Performance Questionnaire PPQ.docx
DOCX document 31 KB Posted
- Attached to
- Q201--CCN-Next Gen Medical
- Solicitation number
- 36C10G26R0003
About this file
This document is a Past Performance Questionnaire (PPQ) issued by the Department of Veterans Affairs for evaluating a contractor's performance history. The questionnaire is designed to gather detailed feedback from previous clients, with a comprehensive rating system that scores performance across seven key areas including overall quality, delivery performance, service quality, problem resolution, and personnel effectiveness. The ratings range from 1 (below standard) to 5 (consistently exceeding standards), with additional sections inquiring about contract terminations, option exercises, contract value, and willingness to re-engage the contractor. The PPQ is specifically linked to the Community Care Network (CCN) Next Generation Medical solicitation (Solicitation Number: 36C10G26R0003), which appears to be a significant medical services procurement opportunity for the VA.
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Text version
ATTACHMENT A: PAST PERFORMANCE QUESTIONAIRRE
Past Performance Questionnaire Department of Veterans Affairs: <Sol. Number>
| E-MAIL TO: Contract Specialist | AGENCY: Veterans Affairs (VA) | |
| E-MAIL: xxx@va.gov | PHONE: xxx-xxx-xxxx |
INFORMATION REQUEST: PAST PERFORMANCE
This office is currently in the process of awarding a competitive service contract. [CONTRACTOR NAME] has provided your name and organization as a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT NO.].
PAST PERFORMANCE QUESTIONNAIRE
Offeror’s Name:
Request for Proposal: <Program/ Requirement Name>
Name of Person Completing the Evaluation:
| Telephone: | E-mail: | |
| Title: | Company/Organization: |
Please rate the offeror in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.
· Not Applicable: N/A
· 1: Performance clearly below the contract performance standard or requirement
| · 2: | Performance occasionally does not meet minimum contract performance standard or requirement |
| · 3: | Performance that meets the minimum contract performance standard or requirement |
| · 4: | Performance that meets and occasionally exceeds the contract performance standard or requirement |
| · 5: | Performance that almost always exceeds the contract performance standard or requirement |
| 1. Overall quality/satisfaction |
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
Overall satisfaction with the offeror’s performance. Would you (the reference) choose to work with this offeror again?
| 2. Delivery performance |
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.
| 3. Satisfaction with the quality of service delivered |
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.
| 4. Satisfaction with problem resolution |
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
This includes the offeror’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.
| 5. Satisfaction with the quality of contractor personnel |
| N/A |_| |
| 1 |_| |
| 2 |_| |
| 3 |_| |
| 4 |_| |
| 5 |_| |
Rate the quality of the contractor’s staff in executing the project work scope.
1. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years? |_| Yes |_| No If Yes, please explain.
1. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.
1. Based on the offeror’s overall performance, would you award them another contract? |_| Yes |_| No If No, please explain.
1. Have you discussed any adverse past performance problems with the Offeror and given them an opportunity to comment? |_| Yes |_| No Please explain.
1. Do you file past performance information in a database that the Contracting Officer may search? |_| Yes |_| No Please explain.
1. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.
1. What was the contract period of performance (i.e., when were services provided)?
1. What was the dollar value of the contract performed by the offeror?
1. Provide a brief description of the services provided by the offeror for this contract.
Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Offeror’s past performance by the evaluator.
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