ATTACHMENT B_ Past Performance Template.docx

ATTACHMENT C. 3: PAST PERFORMANCE QUESTIONAIRRE (PPQ)

Past Performance Questionnaire Department of Veterans Affairs: RFQ# 36C10X24Q0181

INFORMATION REQUEST: PAST PERFORMANCE

This office is currently in the process of awarding a competitive task order. [CONTRACTOR NAME] has provided your name and organization as a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT NO.].

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Quoter’s Name:

Request for Quote: 36C10X24Q0181_ Department of Veterans Affairs Central Office (VACO) Automated External Defibrillator (AED) program maintenance and licenses.

Name of Person Completing the Evaluation:

Please rate the quoter in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.

· Not Applicable: N/A

· 1: Performance clearly below the contract performance standard or requirement

Overall satisfaction with the quoter’s performance. Would you (the reference) choose to work with this quoter again? (Additional Comments Here)

Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions. (Additional Comments Here)

Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those. (Additional Comments Here)

This includes the quoter’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions. (Additional Comments Here)

Rate the quality of the contractor’s staff in executing the project work scope. (Additional Comments Here)

1. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years? |_| Yes |_| No If Yes, please explain.

1. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.

1. Based on the quoter’s overall performance, would you award them another contract? |_| Yes |_| No If No, please explain.

1. Have you discussed any adverse past performance problems with the quoter and given them an opportunity to comment? |_| Yes |_| No Please explain.

1. Do you file past performance information in a database that the Contracting Officer may search? |_| Yes |_| No Please explain.

1. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.

1. What was the contract period of performance (i.e., when were services provided)?

1. What was the dollar value of the contract performed by the quoter?

1. Provide a brief description of the services provided by the quoter for this contract.

Please attach any past performance database reports or other material you deem appropriate to a full understanding of the quoter’s past performance by the evaluator.