ATTACHMENT C PAST PERFORMANCE QUESTIONNAIRE.docx
DOCX document 31 KB Posted
- Attached to
- R408--FY22: Radiation Safety Officer Services
- Solicitation number
- 36C24822Q1417
About this file
This document contains a past performance questionnaire template for evaluation of contractors providing Radiation Safety Officer services. The questionnaire includes eight questions rating aspects of performance such as quality, cost control, timeliness, and compliance. Respondents are instructed to select a rating and provide supporting narrative defined as Exceptional, Very Good, Satisfactory, or Marginal. The questionnaire requests signature and return by July 29, 2022 to two named individuals at the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8.
The related federal contract opportunity is solicitation number 36C24822Q1417 for Radiation Safety Officer services to be awarded by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8. No further details are provided on the required services, response date, or other terms.
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PAST PERFORMANCE QUESTIONNAIRE ATTACHMENT C
RFQ 36C24822Q1417, Radiation Safety Officer Services
Section I is to be completed by the offeror and provide a copy to your references with instructions to complete Section II through IV and submit to the Contracting Officer prior to the offer due date/local time. Contractor shall submit a completed copy of section I with their quote.
SECTION I:
Contractor:
Contractor UEI#:
Contract Number:
Contract Title:
Rater Name:
Rater Telephone:
Rater E-Mail Address:
Rater’s Role in Relation to the Contract (program/project manager, contracting officer, major end user)
INDEX
Section I – Contractor Section II – Ratings Section III – Additional Narrative Justification Section IV – Signature of Rater Section V – Return Instructions Section VI – Rating Definitions
| SECTION II-RATINGS |
| Select a Rating Category |
Contractor Performance
1. How would you rate the quality of the contractor to provide Radiation Safety Officer services?
Supporting narrative: see rating definitions
Choose an item.
2. How would you rate the contractor’s ability to control costs?
Choose an item.
3. How would you rate the contractor’s timeliness for meeting any deliverables or task assigned?
Supporting narrative: see rating definitions
Choose an item.
4. How would you rate the contractor’s ability to comply with the terms and conditions of the contract.
Supporting narrative: see rating definitions
Choose an item.
5. How would you rate the contractor’s ability to effectively manage, coordinate, and integrate subcontractors?
Supporting narrative: see rating definitions
Choose an item.
6. How would you rate the contractor’s communication with the COR/Program Manager?
Supporting narrative: see rating definitions
Choose an item.
7. How would you rate the contractor’s ability to submit requested reports on time?
Supporting narrative: see rating definitions
Choose an item.
8. How would you rate your overall satisfaction with the contractor’s performance?
Choose an item.
SECTION III – Additional Supporting Narrative, if required.
Include the number of the question above to which this supporting narrative applies.
SECTION IV – Signature of Rater
Rater Name:
Signature of rater: _______________________________________ Date: __________________________________________________ Signature of rater is not required if sent via e-mail directly from rater.
SECTION V – Return Instructions
Return the completed questionnaire via e-mail to rohan.mckenzie@va.gov and kurt.kramer@va.gov no later than 13:00, July 29, 2022, EASTERN DAYLIGHT TIME (EDT).
SECTION VI – Rating Definitions
| Rating |
| Definition |
| Note |
Exceptional (E)
| Performance met contractual requirements and exceeded many to the government’s benefit. The contractual performance of the element or sub element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| To justify an “exceptional” rating, identify multiple significant events and state how they were of benefit to the government. A singular benefit, however, could be of such magnitude that it alone merits an “exceptional” rating. Also, there should have been no significant weaknesses identified. |
Very Good
(VG)
| Performance met contractual requirements and exceeded some to the government’s benefit. The contractual performance of the element or sub element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| To justify a “very good” rating, identify a significant event and state how it was a benefit to the government. There should have been no significant weaknesses identified. |
Satisfactory (S)
| Performance met contractual requirements. The contractual performance of the element or sub element contained some minor problems for which corrective actions taken by the contractor appeared to be or were satisfactory. |
| To justify a “satisfactory” rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been no significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than “satisfactory” solely for not performing beyond the requirements of the contract/order. |
Marginal (M)
| Performance did not meet some contractual requirements. The contractual performance of the element or sub element being evaluated reflected a serious problem for which the contractor did not identify corrective actions. The contractor’s proposed actions were only marginally effective or were not fully implemented. |
| To justify a “marginal” performance rating, identify a significant event in each category that the contractor had trouble overcoming and state how it affected the government. A “marginal” rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter). |
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