Attachment 8 (Exhibit B) Past and Present Performance Questionnaire.docx
DOCX document 32 KB Posted
- Solicitation number
- 36C24822R0136
About this file
This document contains a past and present performance questionnaire template for evaluation of contractors on a Department of Veterans Affairs solicitation for physical security improvements. The solicitation will provide all equipment, labor, materials, and services to harden utility and vehicle entrances, perimeter fences, and upgrade the mailroom to meet VA security standards at the Lee County VA Clinic in Cape Coral, Florida. Work must be completed within 232 calendar days of award. Contractors should submit the completed performance questionnaire from past clients to the VA Contracting Officer by the date listed in the solicitation. References will evaluate contractors on a scale of 1 to 6 on criteria such as management quality, personnel retention, quality control, scheduling, and responsiveness. Subcontractor payment timeliness and overall performance are also addressed.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24822R0136 Correct LCHCC Physical Security Def RFIs.xlsx | XLSX spreadsheet | |
| 36C24822R0136 0007.pdf | ||
| July 21 site visit sign in sheet.pdf | ||
| 36C24822R0136 0006.pdf | ||
| 36C24822R0136 0005.pdf | ||
| 36C24822R0136 0004.pdf | ||
| 36C24822R0136 0003.pdf | ||
| 516-19-125 LEE COUNTY100CD 20210409.pdf | ||
| 36C24822R0136 0002.pdf | ||
| 36C24822R0136 0001.pdf | ||
| site plan with scope areas.pdf | ||
| site plan 1.pdf | ||
| site plan 2.pdf | ||
| 36C24822R0136_1.pdf | ||
| 516-19-125 Lee County Specifications.pdf | ||
| Copy of Attachment 4 - Price Matrix.xlsx | XLSX spreadsheet | |
| 36C24822R0136_1.pdf | ||
| Attachment 7- (Exhibit A) Performance Relevancy Survey v2.docx | DOCX document | |
| Lee County Wage Determination 2022.pdf | ||
| Attachment 6 -(Exhibit C) EMR.docx | DOCX document | |
| 516-19-125 LEE COUNTY100CD 20210409 drawings.pdf | ||
| Copy of attachment 9 - q_a rfis.xlsx | XLSX spreadsheet |
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Text version
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS TO CONTRACTOR
Complete the CONTRACTOR INFORMATION section, below (type answers into light blue shaded boxes). Save the document. Send an electronic or hard copy print of the form to each of your reference contacts, asking them to please complete the form and submit it according to the instructions, below. It is preferred that these are the same clients/projects that you provided with Exhibit A for ease of evaluation and comparison. Projects should be relevant (within the same magnitude of construction) and recent (within 5 years).
INSTRUCTIONS TO REFERENCE CONTACT
The contractor named below is submitting an offer for a United States Department of Veterans Affairs contract requirement, and has sent this form to you, in your role as a past performance reference contact. Please complete this form in full (all areas shaded in light yellow, below). Once completed, please send the form to the Contract Specialist via email directly to:
Department of Veterans Affairs NCO 8 Contracting Office TO: Contracting Officer/ Specialist REF SOLICITATION NUMBER :
Email Address: listed in solicitation
Please return as stated in Solicitation. If you have any questions, please contact Amber Milton via email. Thank you for your assistance in this matter.
GENERAL INFORMATION [completed by Contractor]
Contractor Company Name
Street Address
Contractor Point of Contact Name
City
Point of Contact Phone Number
State
Reference Project Title
Zip Code
Contract POP (start to finish):
Contract Number
Contract Dollar Value
Description of Work
| Role of Contractor on This Project (check appropriate box) |
| ☐ Prime Contractor ☐ Sub-contractor ☐ Key Personnel |
RESPONDENT INFORMATION [completed by Reference Contact]
Company Name
Street Address
POC Name
City
Phone Number
State
Fax Number
Zip Code
PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2 in the applicable text box OR in the Remarks section, below (text box will expand to whatever extent is necessary).
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| UNSATISFACTORY |
| MARGINAL |
| SATISFACTORY |
| VERY GOOD |
| EXCEPTIONAL |
| NEUTRAL |
| Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. |
| Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective. |
| Performance met contractual requirements. There were some minor problems and corrective actions taken by the contractor are satisfactory. |
| Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner. |
| Performance met all contract requirements and exceeded many to the government’s benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner. |
| No record of past performance or the record is inconclusive |
| The Contractor … |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| 1. |
| Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 2. | |||||
| Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 3. | |||||
| Delegated authority to project managers and supervisors commensurate with contract requirements. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 4. | |||||
| Home office participated in solving significant local problems. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 5. | |||||
| Followed approved quality control plan. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 6. | |||||
| Provided effective quality control and/or inspection procedures to meet contract requirements. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 7. | |||||
| Corrected deficiencies in timely manner and pursuant to their quality control procedures. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 8. | |||||
| Provided timely resolution of contract discrepancies |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 9. | |||||
| Identified problems as they occurred. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 10. | |||||
| Suggested alternative approaches to problems. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 11. | |||||
| Displayed initiative to solve problems. |
Narrative
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 12. | |||||
| Developed realistic progress schedules. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 13. | |||||
| Met established project schedules. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 14. | |||||
| Provided timely resolution of warranty defects. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 15. | |||||
| Was responsive to contract changes. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 16. | |||||
| Provided adequate project supervision. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 17. | |||||
| Obtained consent of surety for increases in bonding as work-in-progress increased. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 18. | |||||
| Paid subcontractors/suppliers in a timely manner. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 19. | |||||
| Provided accurate and complete line item cost proposals including all aspects of work required for each task. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 20. | |||||
| Cooperated with Government personnel after award. |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 21. | |||||
| How would you rate the contractor's overall performance? |
Narrative:
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| 22. | |||||
| Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” |
| ☐ | YES |
| ☐ | NO |
| 23 |
| Would you award another contract to this contractor? If not, please explain in “remarks.” |
| ☐ | YES |
| ☐ | NO |
| 24 | |
| To the best of your knowledge, is the contractor rated in CPARS? | |
| ☐ | YES |
| ☐ | NO |
REMARKS (Please use as much space as is needed – the box will expand as you type).
| Printed Name/ Title | Signature | |
| Source Selection Sensitive-See FAR Part 3.104Page 22 of 32 |
Source Selection Information--See FAR 2.101 and 3.104
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