ATTACHMENT C - PAST PERFORMANCE.docx
DOCX document 20 KB Posted
- Solicitation number
- 36C77620Q0159
About this file
This combined synopsis and solicitation requests quotes for administration of the VA All Employee Survey. The VA is seeking a contractor to administer the survey via web, phone, and paper modalities; collect and validate data; and provide monthly reporting. The base period of performance is one year with four optional one-year extensions. Quotes are due by August 28, 2020 and the award will be a SDVOSB set-aside. The contractor will be responsible for developing the survey instrument, providing help desk support, collecting and merging responses, calculating and updating response rates, and delivering data files and reports to the VA. Pricing should be provided for tasks on a firm-fixed-price basis for the base year and each option year. The contractor must also submit past performance examples and accept the terms and conditions as written.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77620Q0159 0002.docx | DOCX document | |
| 36C77620Q0159 0001_1.docx | DOCX document | |
| ATTACHMENT B - QASP - 36C776-20-AP-2232 - FY21-25 AES.docx | DOCX document | |
| 36C77620Q0159_1.docx | DOCX document | |
| ATTACHMENT A - PWS - AES - 36C776-20-AP-2232 .docx | DOCX document |
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Text version
Attachment K
PAST PERFORMANCE QUESTIONNAIRE
The Department of Veterans Affairs, Veterans Health Administration - Program Contracting Activity – Central (PCAC) is considering the Offeror listed below for award of a contract to provide AES services for Veterans Health Administration.
Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate the company’s ability to perform the work as described in the solicitation. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. In addition to submitting this questionnaire, the PCAC may contact you in order to obtain any additional information regarding a contract award.
Please email your completed questionnaire to clement.udeani@va.gov and sharif.ra-el@va.gov no later than the date proposals are due.
**All Email Correspondence for this project must reference the RFQ Number, Project Identifier and Project Title in the subject line of the email:36C77620Q0159, AES
If you have questions regarding the attached questionnaire, or require assistance, please email Adeitra Jimmison and Clayton Smith at clement.udeani@va.gov and sharif.ra-el@va.gov.
Past Performance Information:
Name and Address of Company (Offeror) being evaluated:
Contract Number/Delivery or Task Order Number, Title, & Location of project the Offeror performed:
Evaluator: (The following information will assist in the analysis of the data. Information will be kept confidential)
Name of Evaluator:
Address:
Phone Number:
Position held or function in relation to project:
Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT RATE ON A “+” OR “-“ SCALE. If a “+” or “-“ is used, the rating without the "+" or "-" will be applied. In addition to the ratings, please provide a short narrative in the appropriate block or in the remarks section of this form.
| “O” |
| Outstanding |
| The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the offeror were highly effective. |
| “A” |
| Above Average |
| The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the offeror were effective. |
| “S” |
| Satisfactory |
| The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the offeror were satisfactory. |
| “U” |
| Unacceptable |
| Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the offeror has yet to identify corrective actions or the offeror’s proposed actions appear only marginally effective or were not fully implemented. |
Please rate and provide any supporting information/comments for the following:
1. The quality of the working relationship with the client (the tenant and/ or owner).
O A S U
2. The professionalism and integrity with which offeror conducted business.
O A S U
3. The responsiveness to the client’s needs and expectations.
O A S U
4. The Offeror’s ability to manage and perform the project successfully.
O A S U
5. The offeror’s level of communication.
O A S U
6. The quality control of the project.
O A S U
7. Would you award another contact to the party being evaluated? If no, please explain.
Yes No
8. The delivery of the project was on schedule.
O A S U
9. Overall rating for this firm:
O A S U
Signature of Evaluator
Date
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