Attachment C - PAST PERFORMANCE QUESTIONNAIRE.docx

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Attached to
Renovate 2nd Floor 113A and Medical Specialty in Bldg. 110 at Hampton VAMC, Virginia.
Solicitation number
36C24624R0066
Issued by

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This document is a Past Performance Questionnaire that is part of a federal contract opportunity. The federal contract opportunity is for Architect-Engineer (A/E) services to renovate the 2nd floor 113A and medical specialty areas in Building 110 at the Hampton VA Medical Center in Virginia. The estimated construction value is between $500,000 and $1,000,000. The A/E services contract will be a negotiated Firm-Fixed Price contract with a period of performance of 490 calendar days for the design and 400 calendar days for construction period services, for a total of 1,290 calendar days. This procurement is a 100% Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside. Offerors must provide a minimum of 3 and a maximum of 5 examples of past performance on similar contracts exceeding $500,000 in value. The Past Performance Questionnaire requests details on the customer, contract value, contract term, contract status, and scope of work performed.

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Attachment A - EVALUATION CRITERIA.docx DOCX document
Attachment D - SF330.pdf PDF
Attachment B - EVALUATION PROCESS.docx DOCX document
36C24624R0066.docx DOCX document

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ATTACHMENT B: PAST PERFORMANCE QUESTIONNAIRE

Please list your contracts in chronological order beginning with the most recent one. Offerors must provide a minimum of three (3) and a maximum of five (5) examples of their choice of completed projects or in progress of similar contracts in size and scope with a minimum threshold value exceeding $500,000. See Criterion 2 – Corporate Experience for all required information to be included.

Contract #1

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status ___Ongoing ___Completed

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

RFP 36C24624R0066

Contract #2

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #3

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #4

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #5

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

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