Attachment B - Past Performance Questionnaire.docx
DOCX document 19 KB Posted
- Attached to
- Equine Therapy Services Federal contract opportunity
- Solicitation number
- 36C24424Q0323
About this file
This document contains a past performance questionnaire template for a federal solicitation seeking equine therapy services. The solicitation is open to full and open competition, with responses due by February 15, 2024. The Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4 is the contracting agency. The questionnaire is to be completed by a reference for each offeror's past or current contracts performing similar services and addresses factors including quality of services, timeliness, and business relations. Ratings on a scale of Excellent to Unsatisfactory are required for various performance elements. The questionnaire requests key details about prior contracts and seeks an overall past performance rating.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment C - Price Schedule.docx | DOCX document | |
| Attachment D - Wage Determination - 2015-4223 Rev - 25 Date 12-26-2023.pdf | ||
| Combined Synopsis - 36C24424Q0323 - Equine - 562.docx | DOCX document | |
| Attachment A - Statement of Work.docx | DOCX document |
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Text version
ATTACHMENT B
PAST/PRESENT PERFORMANCE QUESTIONNAIRE
SOLICITATION NUMBER – 36C24424Q0323
Equine Therapy Services
PLEASE COMPLETE THE FOLLOWING IDENTIFYING INFORMATION AND PAST PERFORMANCE ASSESSMENT. PLEASE SEND THE COMPLETED FORM TO EDWARD FERKEL, EDWARD.FERKEL@VA.GOV. SOLICITATION CLOSE DATE IS FEBRUARY 15, 2024 AT 10:00AM.:
I. CONTRACTOR IDENTIFICATION:
Contractor:
Contract Number:
Period of Performance:
Negotiated price or cost at award:
Current estimated contract dollar amount:
Describe service acquired:
II. EVALUATOR INFORMATION:
Name:
Organization:
Phone Number:
Relation to Program:
(i.e., Contracting Officer, Program Manager, Contract Specialist/Administrator, Contracting Officer's Technical Representative, etc.)
Time On Contract:
III. ASSESSMENT ELEMENTS: Narrative statements are vital. Please provide a narrative for each element below and then an adjectival rating under pars. III.A2, III.B.2, III.C.2, and an overall Past/Present Performance Adjectival Rating under par. III.F based on the attached Adjectival Rating Descriptions. Attach additional pages if there is insufficient space in the comment space.
PERFORMANCE ADJECTIVAL RATINGS: Choose the appropriate adjective that most accurately describes the contractor’s performance based on the descriptions below.
| EXCELLENT |
| GOOD |
| SATISFACTORY |
| MARGINAL |
| UNSATISFACTORY |
Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.
Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.
Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective actions taken by the contractor were satisfactory.
Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
A. QUALITY OF SERVICES
1. Narrative: Address the Contractor’s ability to provide qualified personnel (including experienced managers and/or supervisors), necessary equipment which is properly maintained, quality control for the performance of your contract, and contractor’s compliance with contractual terms and conditions.
2. Rating for Quality of Services: (Please check one and provide a narrative explanation of a Marginal or Unsatisfactory rating):
|_| Excellent |_|Good |_|Satisfactory |_|Marginal |_|Unsatisfactory
| B. TIMELINESS OF PERFORMANCE: | ||
| 1. Narrative: Address the Contractor’s ability to meet the contract’s | specific response times and Contractor’s timeliness in providing any | administrative reports/documents required by your contract. |
2. Rating for Timeliness of Performance: (Please check one and provide a narrative explanation of a Marginal or Unsatisfactory rating):
| C. BUSINESS RELATIONS | ||
| 1. Narrative: Address Contractor’s willingness to improve and correct | noncompliance issues and concerns. Describe Contractor’s ability to correct problems and prevent or mitigate potential problems in a timely manner. Does Contractor display initiative and flexibility? Do Contractor personnel promote a strong working relationship with your agency/organization? Are Contractor personnel courteous and | responsive? Do Contractor personnel interface effectively with your staff? |
2. Rating for Business Relations: (Please check one and provide a narrative explanation of a Marginal or Unsatisfactory rating):
D. Identify the contractor’s overall strengths and weaknesses:
E. Given the choice, would you award to this contractor again?
YES |_| NO |_|
If no, please explain:
F. CONTRACTOR’S OVERALL PAST/PRESENT PERFORMANCE RATING: (Please check one and provide a narrative explanation of a Marginal or Unsatisfactory rating):
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