ATTACHMENT A - PP Questionnaire Referral Lab.docx
DOCX document 24 KB Posted
- Attached to
- Q301--REFERENCE LAB TESTING
- Solicitation number
- 36C25626Q0367
About this file
This is a Past Performance Questionnaire designed to evaluate contractor performance for reference laboratory testing services provided to the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 under Solicitation Number 36C25626Q0367. The questionnaire requests information from previous customers of prospective offerors regarding their experience with laboratory courier services, testing quality and timeliness, customer service effectiveness, and technical system integration capabilities.
Respondents are asked to rate contractor performance across four primary evaluation areas using a numerical scale (0-3), with ratings ranging from Poor to Excellent. The evaluation criteria focus on courier service professionalism and specimen handling, adherence to published turnaround times and critical value reporting, availability of collection supplies and local account support, and successful establishment and maintenance of electronic ordering and reporting system interconnections. Additional assessment areas include overall contractor performance satisfaction, contractor failures, and likelihood of contract renewal. Completed questionnaires must be submitted to Arlene A. Blade at arlene.blade@va.gov by March 5, 2026 at 4:30 p.m. CST. The document notes that contractors may be notified of adverse remarks with opportunity to respond, but respondent identity and questionnaire contents will remain confidential per Federal Acquisition Regulations.
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Other files
| File | Type | Posted |
|---|---|---|
| SF30 - AMENDMENT TO RFQ.pdf | ||
| Copy of SCHEDULE.xlsx | XLSX spreadsheet | |
| 36C25626Q0367.docx | DOCX document |
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Text version
PAST PERFORMANCE QUESTIONNAIRE / EVALUATION FACTOR
Project/Contract No: Name of Offeror: ____________
Name and Title of Person Completing Questionnaire: _____________________________
Company/Organization:_ _______________________________________
Effective date & ending date of contract (include all option periods):
Annual contract value/cost:
Total contract value/cost:
Scope of services performed:
Breadth of testing menu performed:
Annual volume of testing performed:
Additional pertinent information related to your experience with the Offeror:
Please return this Past Performance Questionnaire by March 5, 2026 at 4:30pm CST to: Arlene A. Blade at arlene.blade@va.gov Questions?
RATING DEFINITIONS
| 3 |
| Excellent: Performance greatly exceeded contract requirements resulting in overall benefits to the customer with no significant weaknesses or complaints. |
| 2 |
| Ver Very Good: Performance consistently met and often exceeded many of the contract require- |
ments with very few weaknesses or complaints.
| 1 |
| Satisfactory: Performance consistently met contract requirements with noted weaknesses or complaints adequately corrected. |
| 0 |
| Poor: Performance consistently failed to meet contract requirements with numerous significant weaknesses or complaints. |
Past Performance Question
Rating (enter numerical ratings)
1. Rate the level of courier services performed by the Contractor to include professionalism, adherence to defined pick-up schedules, specimen handling requirements, and packaging for transport. Describe missed pick-ups, loss of shipments, delays, and other failures in specimen transport.
Comments:
2. Rate the quality and timeliness of testing performed. Did the contractor consistently meet published turn-around-times and contract requirements? Were critical values reported appropriately and in a timely manner?
3. Rate the effectiveness of contractor customer service with regard to the following: providing required collection supplies as requested, availability and responsiveness of local account representative, as well as responsiveness of contractor staff for test changes, test inquiries, and resolution of invoicing issues.
4. Rate the success/responsiveness of the contractor in successfully establishing a fully operational interconnection for automatic electronic ordering and reporting of results between contractor laboratory information system (LIS) and your LIS, resolving site to site connectivity and other related technical problems/challenges to ensure continuous successful operation of the established interconnection.
How satisfied were you with the contractor’s overall performance? Describe any contractor failures. Would you award another contract to this contractor?
Please explain:
ADDITIONAL COMMENTS:
PLEASE NOTE: In accordance with Federal Acquisition Regulations, contractors may be advised of adverse remarks and given an opportunity to respond. However, the Contracting Officer will not provide your name or copies of this questionnaire to the contractor or any other party not directly involved in the evaluation of the contractor’s proposal.
THANK YOU FOR YOUR RESPONSE!
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