ATTACHMENT 4 PAST PERFORMANCE REFERENCE QUESTIONNAIRE.pdf
PDF 233 KB Posted
- Solicitation number
- 36C24822R0104
About this file
This document contains a past performance reference questionnaire template for a roof replacement project at a Department of Veterans Affairs medical center building. The questionnaire requests ratings on quality, cost control, timeliness, special needs support, subcontractor management, small business subcontracting, warranty support, and overall satisfaction. Respondents are asked to provide narrative justifications for their ratings. The questionnaire is to be returned by the date and time listed in solicitation number 36C24822R0104 for the roof and gutter system replacement project at the West Palm Beach VA Medical Center building 10.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24822R0104 0001.docx | DOCX document | |
| ATTACHMENT 8 SPEC 014219.pdf | ||
| ATTACHMENT 3 LOS CERTIFICATION SOLICITATION.pdf | ||
| ATTACHMENT 10 AS BUILTS EXISTING ROOF BUILDING 10.pdf | ||
| ATTACHMENT 6 SPEC 01321615.docx | DOCX document | |
| ATTACHMENT 7 SPEC 013526.docx | DOCX document | |
| 36C24822R0104.docx | DOCX document | |
| ATTACHMENT 2 CONTRACTORS INQUIRY.pdf | ||
| ATTACHMENT 9 VAMC SITE MAP .pdf | ||
| ATTACHMENT 5 SPEC 076114.pdf | ||
| ATTACHMENT 1 - EMR.pdf |
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PAST PERFORMANCE REFERENCE QUESTIONNAIRE
RFQ 36C24822R0104, Roof Replacement Building 10
<Header section is to be completed by the offeror and provided to the reference with instructions to submit the completed questionnaire directly to the government contact identified in section IV.>
Contractor:
Contract Number:
Contract Name:
Rater Name:
Rater Telephone:
Rater E‐Mail Address:
Rater’s Role in Relation to the Contract (program/project manager, contracting officer, major end user, etc.):
Rating Definitions
Rating Definition Note
Exceptional (E)
Performance met contractual requirements and exceeded many to the government’s benefit. The contractual performance of the
To justify an “exceptional” rating, identify multiple significant events and state how they were of benefit to the government.
A singular benefit, however, could be of such magnitude that element or sub element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
it alone merits an “exceptional” rating. Also, there should have been no significant weaknesses identified.
Very Good
(VG)
Performance met contractual requirements and exceeded some to the government’s benefit. The contractual performance of the element or sub element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
To justify a “very good” rating, identify a significant event and state how it was a benefit to the government. There should have been no significant weaknesses identified.
Satisfactory (S)
Performance met contractual requirements.
The contractual performance of the element or sub element contained some minor problems for which corrective actions taken by the contractor appeared to be or were satisfactory.
To justify a “satisfactory” rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been no significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than “satisfactory” solely for not performing beyond the requirements of the contract/order.
Marginal (M)
Performance did not meet some contractual requirements. The contractual performance of the element or sub element being evaluated reflected a serious problem for which the contractor did not identify corrective actions.
The contractor’s proposed actions were only marginally effective or were not fully implemented.
To justify a “marginal” performance rating, identify a significant event in each category that the contractor had trouble overcoming and state how it affected the government.
A “marginal” rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).
INDEX
Section I – Ratings Section II – Additional Narrative Justification Section III – Signature of Rater Section IV – Return Instructions Section V – Contact Information
Please provide any relevant information to support the above ratings.
<Note: When completing this questionnaire by e‐mail, please do not use a color, such as red, to select the rating in section I of this questionnaire. Color fonts do not show well when printed. Just bold it, underline it, or increase the font size in black.>
Unsatisfactory (U)
Performance did not meet most contractual requirements and recovery was not accomplished in a timely manner. The contractual performance of the element or sub element contained a serious problem(s) for which the contractor’s corrective actions were ineffective.
To justify an “unsatisfactory” rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it affected the government.
A singular problem, however, could be of such serious magnitude that it alone merits an “unsatisfactory” rating. An “unsatisfactory” rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency report or letter.
Section I
Contractor Performance
1. How would you rate the quality of the contractor’s products/services provided?
Supporting narrative: <see above criteria>
Response
E VG S M U N/A
2. How would you rate the contractor’s ability to control costs?
3. How would you rate the contractor’s timeliness of the products/services delivered?
E VG S M U N/A
4. How would you rate the contractor’s ability to meet special needs (such as expedited delivery or crisis support) for delivery requirements?
Supporting narrative: <see above criteria>
E VG S M U N/A
5. How would you rate the contractor’s ability to effectively manage, coordinate, and integrate subcontractors?
6. How would you rate the contractor’s performance on small business subcontracting?
7. How would you rate the performance of the contractor’s warranty/maintenance?
E VG S M U N/A
8. How would you rate your overall satisfaction with the contractor’s performance?
Section II
Additional Supporting Narrative, if required: <Include the number of the question to which this supporting narrative applies.
Additional pages may be used.>
Section III
Signature of rater:
Date:
<Signature of rater is not required if sent via e‐mail directly from rater.>
Section IV
Return the completed questionnaire via e‐mail to: Katy.Werby@va.gov
Please return the completed questionnaire by: date and time listed in RFQ Section INSTRUCTIONS TO OFFERORS
Section V
For any questions pertaining to the questionnaire, please contact Katy Werby at katy.werby@va.gov.
mailto:Katy.Werby@va.gov mailto:katy.werby@va.gov
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