Attachment 7 - Past Performance Questionnaire.docx
DOCX document 27 KB Posted
- Solicitation number
- 36C10G22R0020
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Other files
| File | Type | Posted |
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| Attachment 8 Technical Evaluation Matrix as of Amendment 0001.xlsx | XLSX spreadsheet | |
| Attachment 3 - Excel Price-Cost Schedule as of Amendment 0001.xlsx | XLSX spreadsheet | |
| 36C10G22R0020 0001.docx | DOCX document | |
| MRDT Questions Compiled as of Amendment 0001 final.xlsx | XLSX spreadsheet | |
| Attachment 6- Question Submission Format.xlsx | XLSX spreadsheet | |
| Attachment 3 - Excel Price-Cost Schedule.xlsx | XLSX spreadsheet | |
| Attachment 8 Technical Evaluation Matrix.xlsx | XLSX spreadsheet | |
| 36C10G22R0020_2.docx | DOCX document | |
| Attachment 1 - Invoice Inquiry Tracker.xlsx | XLSX spreadsheet | |
| Attachment 4 - Pay.gov Vendor Submittal Instructions.docx | DOCX document | |
| Attachment 5 - HIPAA-Business Associate Agreement.docx | DOCX document | |
| Attachment 2 Contractor Discrepancy Report.pdf |
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36C10G22R0020 Attachment 7
Department of Veterans Affairs:
INFORMATION REQUEST: PAST PERFORMANCE QUESTIONNAIRE
The Department of Veterans Affairs is currently in the process of awarding a competitive enterprise wide strategic contract for Minimal Residual Disease (MRD) Testing Services. This Questionnaire has been sent to you for a reference for solicitation:
Send completed questionnaires to michelle.bailey@va.gov and zachary.wilcox@va.gov.
Please fill the subject line of the e-mail as: [Company Name] – Past Performance Questionnaire– [Insert Solicitation Number].
NOTE TO CONTRACTORS: If the Questionnaire is provided for Subcontractors reference, the Contractor’s name below must include both the Prime and Subcontractor Names.
PAST PERFORMANCE QUESTIONNAIRE
Contractor’s Name:
Subcontractor’s Name (if applicable):
BPA/Contract/Task Order Number:
Name of Person Completing the Evaluation:
Telephone: E-mail:
Title:
Dollar Value of Contract: ____________________________________________
Company/Organization:
Please rate the contractor in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation. Please provide an answer for each question even if the response is Not Applicable (NA)
· 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 Contractor’s performance.
| 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 contractor’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.
7. 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.
8. 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.
9. Based on the contractor’s overall performance, would you award them another contract?
|_| Yes |_| No If No, please explain.
10. Have you discussed any adverse past performance problems with the Contractor and given them an opportunity to comment? |_| Yes |_| No Please explain.
11. Do you file past performance information in a database that the Contracting Officer may search?|_| Yes |_| No Please explain.
12. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.
13. What was the contract period of performance (i.e., when were services provided)?
14. What was the dollar value of the contract performed by the contractor?
15. Provide a brief description of the services provided by the contractor for this contract.
Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Contractor’s past performance by the evaluator. Please provide information on any adverse performance by the contractor and the corrective actions taken.
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