Attachment 8 Past and Present Performance Questionnaire.docx
DOCX document 33 KB Posted
- Solicitation number
- 36C24821R0129
About this file
This document contains a past and present performance questionnaire for a federal contract solicitation. The U.S. Department of Veterans Affairs is seeking a service-disabled veteran-owned small business to renovate clinical research laboratories at the Malcom Randall VA Medical Center in Gainesville, Florida. Interested contractors must submit past performance information demonstrating experience with similar design and construction projects by August 27, 2021 to the contracting officer. The questionnaire collects information about the contractor's performance on a previous project, including ratings in areas such as management, quality control, scheduling, and cooperation with government personnel. Reference contacts are asked to evaluate the contractor's performance and indicate if they would award another contract to the firm.
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Text version
573-18-618 BB - Renovate Clinical Research Laboratories, at the Malcom Randall VAMC Network Contracting Office (NCO) 8 Solicitation No. 36C24821R0129
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: Amber Milton, Contracting Officer REF: 36C24821R0129 Email Address: amber.milton@va.gov
Please return the completed form no later than August 27, 2021. 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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