Attachment 8- PERFORMANCE QUESTIONNAIRE.docx

SAMPLE COVER LETTER

AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

You’re Company Letterhead

Date: _________________

To: ______________________________________

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the Department of Veterans Affairs, Office of Construction & Facilities Management. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please email your completed questionnaire to the following email address to arrive NOT LATER THAN <Add Due Date>.

Email response to: Alea.Barnes@va.gov

If you have questions regarding the attached questionnaire, or require assistance, please contact Alea Barnes, Contracting Officer at alea.barnes@va.gov.

Thank you for your assistance.

Signature and Title

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and return it via email to: Alea Barnes (Alea.Barnes@va.gov)

Desired Response Date: <Add Due Date>.

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1a. CONTRACTOR NAME & ADDRESS:

2. CONTRACT NO.:

3. CONTRACT AWARD DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

1b. NAME OF PRIME CONTRACTOR (If this questionnaire is for a team member)

6. TYPE OF CONTRACT:

7. PROJECT TITLE, LOCATION, AND DESCRIPTION (AND TOTAL CONSTRUCTION VALUE AT PROJECT COMPLETION):

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.

A. Quality of Products and Services - Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

E G S M U N/O

B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

E G S M U N/O

C. Schedule – Assess the timeliness of contractor against the schedule of activities.

E G S M U N/O

D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.

E G S M U N/O

E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.

E G S M U N/O

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

E G S M U N/O

G. Overall Assessment.

E G S M U N/O

Comments (for any ratings of E, G, M, or U, please provide some brief comments about strengths & weaknesses you observed in this contractor that help us understand your rating. Feel free to provide additional pages if necessary):