ATTACHMENT B 36C10X23R0037 (PPQ).docx
DOCX document 40 KB Posted
- Attached to
- R426--Solicitation for communication support and paid media for suicide prevention efforts (VA-23-00035099)
- Solicitation number
- 36C10X23R0037
About this file
This document contains a past performance questionnaire and information on a related federal contract opportunity. The past performance questionnaire is a reference form for contractors to provide to past clients regarding prior contract performance on metrics such as quality, schedule, cost control, management, regulatory compliance, and utilization of small businesses. It requests that completed questionnaires be returned via email by a specified date.
The related federal contract opportunity is a solicitation from the Department of Veterans Affairs seeking contractor support services to assist the Office of Mental Health and Suicide Prevention in developing and implementing communication products, outreach strategies, and distribution processes regarding veteran suicide prevention. The goal is to ensure veterans, their families, and VA personnel are aware of VA mental health and suicide prevention resources. The required services include strategic communication development and paid media implementation.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP 36C10X23R0037 A0002 Tracked Changes.docx | DOCX document | |
| ATTACHMENT A_36C10X23R0037 A0002.xlsx | XLSX spreadsheet | |
| RFP 36C10X23R0037 A0002 Conformed.pdf | ||
| 36C10X23R0037 0002.docx | DOCX document | |
| 36C10X23R0037.docx | DOCX document | |
| ATTACHMENT A_36C10X23R0037 (QA Template).xlsx | XLSX spreadsheet | |
| Request for Proposal 36C10X23R0037.pdf |
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Text version
ATTACHMENT B: PAST PERFORMANCE QUESTIONNAIRE (PPQ)
AGENCY: Department of Veterans Affairs, Strategic Acquisition Center - Frederick
REQUEST FOR PROPOSAL: 36C10X23R0037
INFORMATION REQUEST: PAST PERFORMANCE
The Department of Veterans Affairs is currently in the process of awarding a competitive service contract. [CONTRACTOR NAME] has provided this Questionnaire to you for a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT #].
Please send completed Questionnaire to E-MAIL TO: Anthony.Zibolski@va.gov AND Wanda.Edwards@va.gov
NOTE TO OFFERORS: If the Questionnaire is provided for a subcontractor’s reference, the contractor’s name below must include both the subcontractor’s name and the offeror’s name who will be the prime contractor for this solicitation (e.g. contractor X, who will be a subcontractor to offeror Y for this solicitation).
Name of Person Completing the Evaluation:
Telephone: E-mail:
Title:
Company/Organization:
Instructions:
Please rate the contractor in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.
· Exceptional: Performance that almost always exceeds the contract performance standard or requirement
· Very Good: Performance that meets and occasionally exceeds the contract performance standard or requirement
· Satisfactory: Performance that meets the minimum contract performance standard or requirement
· Marginal: Performance occasionally does not meet minimum contract performance standard or requirement
· Unsatisfactory: Performance clearly below the contract performance standard or requirement
· Not Applicable: N/A
| Performance Areas |
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| N/A |
| 1. QUALITY | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the achieved service performance relative to performance parameters required by the contract or order. |
| 2. SCHEDULE | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance). |
| 3. COST CONTROL (Not required for Fixed Price type contracts or orders) | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the Contractor’s effectiveness in forecasting, managing, and controlling contract or order cost. |
| 4. MANAGEMENT | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the integration and coordination of all activity needed to execute the contract or order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts. |
| 5. UTILIZATION OF SMALL BUSINESS | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess compliance with all terms and conditions in the contract or order relating to Small Business participation (including FAR 52.219-8 Utilization of Small Businesses, and FAR 52.219-9 Small Business ☐Subcontracting Plan, when required). |
| 6. REGULATORY COMPLIANCE | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: E.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments. Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes, using the Evaluation Ratings Definitions. |
7. What was the contract period of performance (i.e., when were services provided)?
8. What was the dollar value of the contract performed by the vendor?
9. Provide a brief description of the services provided by the vendor for this contract.
| 10. Overall Recommendation |
| Would |
| Would Not |
| Signed |
| Given what I know today about the contractor’s ability to execute what he promised in his proposal, I _________________ award to him today given that I had a choice. | |
| ☐ | ☐ |
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