Attachment 9 - Past Performance.docx
DOCX document 29 KB Posted
- Attached to
- Y1EZ--Correct FCA Deficiencies Construction -Amendment Federal contract opportunity
- Solicitation number
- 36C77026R00060005
About this file
This is a Past Performance Reference form that prime contractors must complete and distribute to their reference contacts for evaluation in response to Solicitation Number 36C77026R0006, which concerns correcting FCA (Facility Condition Assessment) deficiencies for the CMOP (Community Mental Health Clinic or similar VA facility) at Tucson, Arizona. The form serves as a template for government agencies or companies that have worked with the contractor to provide structured feedback on the contractor's performance history.
Reference contacts must evaluate the contractor across 18 performance criteria using a 0-5 scale (Neutral to Exceptional), including assessments of management experience, personnel qualifications and retention, staffing responsiveness, problem identification and resolution, quality control, contract compliance, and cooperation with government personnel. Critical evaluation areas include the contractor's ability to fill staff vacancies timely, maintain consistent staffing levels, manage on-boarding and background investigations, and respond to contract changes. Reference contacts must also indicate whether the contractor received any cure or show cause notices and whether they would award another contract to the firm. An overall performance rating and detailed remarks explaining the rating are required. Completed forms must be submitted to Billie.Cherico@va.gov, and respondents must certify the accuracy of their responses. This document is part of the VA's evaluation criteria for the Tucson facility deficiency correction project.
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Attachment 9 – Past Performance INSTRUCTIONS TO PRIME CONTRACTOR: (Contractor submitting proposal):
Complete the CONTRACTOR INFORMATION section. 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.
Company Name
Street Address
Point of Contact
City
Point of Contact Phone Number
State
E-Mail Address
Zip Code
| Solicitation Number |
| 36C77026R0006 |
| Description of Work |
| Correct FCA Deficiencies for CMOP at Tucson, AZ. |
INSTRUCTIONS TO REFERENCE CONTACT
Please complete the following pages as a past performance Reference Contract for the entity named above. Once completed, please return the form to: Billie.Cherico@va.gov.
RESPONDENT INFORMATION [completed by Reference Contact]
Government Agency or Company name
Street Address
POC Name
City
Phone Number
State
Fax Number
Zip Code
Contract Number
Prime or Subcontractor
Dollar Value
Period of Performance
Description of services provided
Location of services provided
Number of FTEE YOUR FIRM provided
PERFORMANCE INFORMATION: Choose the number on the scale of 0 (Neutral) to 5 (Exceptional) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE AN EXPLANATION FOR THE OVERALL RATING in the Remarks section, below (text box will expand to whatever extent is necessary).
| 0 |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| NEUTRAL |
| UNSATISFACTORY |
| MARGINAL |
| SATISFACTORY |
| GOOD |
| EXCEPTIONAL |
| No record of past performance or the record is incon-clusive. |
| Performance did not meet most contractual require-ments. 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 most contractual requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory. |
| Performance met all contract requirements and exceeded some. There were a few minor problems, which the contractor resolved in a timely, effective manner. |
| Performance exceeded all contract requirements. There were no problems. |
| The Contractor … |
| 0 |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 1. |
| Provided experienced managers and/or supervisors with the technical and administrative abilities needed to meet contract requirements. |
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| 2. |
| Demonstrated ability to hire, maintain, and replace, if necessary, sufficient qualified personnel throughout the contract period. |
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| 3. |
| Ability to fill staff vacancy in a timely manner. |
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| 4. |
| Home office participated in solving significant local problems as necessary. |
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| 5. |
| Had sufficient personnel to monitor, support and provide oversight for large numbers of staff at geographically dispersed locations. |
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| 6. |
| Provided highly qualified personnel throughout the life of the contract. |
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| 7. |
| Corrected deficiencies in timely manner and pursuant to their quality control procedures. |
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| 8. |
| Provided timely resolution of contract discrepancies |
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| 9. |
| Identified problems as they occurred. |
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| 10. |
| Suggested alternative approaches to problems. |
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| 11. |
| Displayed initiative to solve problems. |
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| 12. |
| Managed on-boarding and background investigation process efficiently and timely. |
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| 13. |
| Was responsive to contract changes. |
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| 14. |
| Maintained consistent staffing levels for positions in cases of call outs, illnesses, injuries, etc. |
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| 15. |
| Cooperated with Company/ Government personnel after award. |
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| 16. |
| Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” |
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| YES |
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| NO |
| 17. |
| Would you award another contract to this contractor? If not, please explain in “remarks.” |
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| YES |
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| NO |
| 18. |
| OVERALL PERFORMANCE RATING: |
| |_| 0 |
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REMARKS (Please use as much space as is needed – the box will expand as you type).
I hereby certify that the information that I have reported above is accurate to the best of my knowledge.
Printed Name
E-mail address
Business Title
Signature
Date
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