ATTACHMENT C - PAST PERFORMANCE QUESTIONNAIRE.docx

Past Performance Questionnaire

Request for Quote (RFQ) No.: 36C10X25Q0033 Title: Veterans Experience Office Contact Center (VEOCC)

INFORMATION REQUEST: PAST PERFORMANCE

The Department of Veterans Affairs is currently in the process of awarding a competitive service contract. [CONTRACTOR'S NAME] has provided this data entry form to you for a reference regarding [CONTRACTOR'S NAME] record of past performance under Contract No. [CONTRACT #]

Please send completed questionnaires to Michael.Stevens5@va.gov and Caitlin.Ruc@va.gov NOTE TO OFFERORS: If the data entry form is provided for subcontractor’s reference, the offeror’s name below must include both the prime and subcontractor names (e.g. contractor X, who is a subcontractor to offeror Y for this solicitation).

Contractor’s Name:

Name of Person Completing the Evaluation:

Telephone: E-mail:

Title:

Company/Organization:

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

Instructions: Please evaluate each of the following areas. Other evaluation areas that are unique to the contract or that cannot be captured elsewhere should be added to the table. Lines 7-9 are in the table for this purpose, but additional lines can be added by references. Comments need to be provided in each instance to support each rating.

Assess the achieved service performance relative to performance parameters required by the contract or order.

Comments (24000 character limit)

Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Assess the Contractor’s effectiveness in forecasting, managing, and controlling contract or order cost.

Assess the integration and coordination of all activity needed to execute the contract or order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Assess compliance with all terms and conditions in the contract or order relating to Small Business participation (including FAR 52.219-8 Utilization of Small Businesses, and FAR 52.219-9 Small Business Subcontracting Plan, when required).

E.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments. Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes, using the Evaluation Ratings Definitions.