Attachment B - Past Performance Questionnaire.docx
DOCX document 19 KB Posted
- Attached to
- H912--238220 | Fire and Smoke Barrier Inspections and Repairs | Lebanon VA Medical Center
- Solicitation number
- 36C24425Q0331
About this file
This is a Past Performance Questionnaire template (Attachment B) for solicitation 36C24425Q0331 for Fire Stop Barrier Repairs and Inspections at Lebanon VA Medical Center. The questionnaire must be completed by previous customers and submitted directly to Eric Christy at the VA before March 18th, 2025 at 3:00 PM Eastern.
The questionnaire requires evaluators to provide contractor identification details, evaluator information, and ratings across three main areas: Quality of Services, Timeliness of Performance, and Business Relations. Ratings use a five-tier scale from Excellent to Unsatisfactory, with narrative explanations required for each category. The form also asks evaluators to identify contractor strengths and weaknesses, whether they would award to the contractor again, and provide an overall past performance rating. Each rating category includes detailed criteria for assessment, such as personnel qualifications, equipment maintenance, quality control, meeting response times, and effectiveness of business relationships.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B VAMC Lebanon FS Survey Report 11_2024_Redacted.pdf | ||
| 36C24425Q0331 0002.docx | DOCX document | |
| 36C24425Q0331 0001.docx | DOCX document | |
| Attachment A.1 - Fire Safety Plans Multiple Buildings Lebanon VAMC.pdf | ||
| 36C24425Q0331.docx | DOCX document | |
| Attachment A - Fire Safety Plans Multiple Buildings Lebanon VAMC.pdf | ||
| P07 WD 2015-4231 Rev27 12-23-2024.pdf |
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Text version
ATTACHMENT B
PAST/PRESENT PERFORMANCE QUESTIONNAIRE
SOLICITATION NUMBER – 36C24425Q0331
Fire Stop Barrier Repairs and Inspections
PLEASE COMPLETE THE FOLLOWING IDENTIFYING INFORMATION AND PAST PERFORMANCE ASSESSMENT. PLEASE SEND THE COMPLETED FORM TO ERIC CHRISTY, ERIC.CHRISTY@VA.GOV BEFORE THE SOLICITATION CLOSE DATE. SOLICITATION CLOSE DATE IS MARCH 18TH, 2025 AT 3:00PM EASTERN:
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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