ATTACHMENT D.2- PAST PERFORMANCE QUESTIONAIRE.pdf

Solicitation

36S79725R0001

PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE QUESTIONNAIRE

Name of Contractor being Evaluated:

Company Providing Reference:

Contract Number:

Nature of Contract:

Contract Period of Performance:

Name and Title of Person Completing Questionnaire:

Company/Organization:

Phone Number/E-mail Address:

PLEASE MAIL THIS COMPLETED QUESTIONNAIRE DIRECTLY TO: VA, VA National Acquisition Center Commodities and Services Acquisition Service Attn: Michelle Williams Solicitation 36S79725R0001, michelle.williams4@va.gov

Describe the nature of your contract with the above referenced Vendor and types/models of products purchased from the Vendor. (If more space is needed, please use the “Additional Comments” block on the second page)

ADJECTIVAL RATING DEFINITIONS

“E” Excellent: Performance greatly exceeded contract requirements resulting in overall benefits to the customer with no significant weaknesses or complaints.

“VG” Very Good: Performance consistently met and often exceeded many of the contract requirements with very few weaknesses or complaints.

“G” Good: Performance consistently met contract requirements with noted weaknesses or complaints adequately corrected.

“F” Fair: Performance often failed to meet minimum contract requirements with numerous noted weaknesses or complaints usually corrected.

“P” Poor: Performance consistently failed to meet contract requirements with numerous significant weaknesses or complaints left uncorrected.

“N” Neutral: No relevant past performance available for evaluation. Receives no merit of demerit for this factor.

PAST PERFORMANCE ADJECTIVAL RATINGS

1. How well were the contract requirements met? E VG G F P N

Comments:

2. To what extent did the contractor adhere to the E VG G F P N schedule?

3. How responsive was the contractor in resolving E VG G F P N quality, schedule, or other contract issues?

4. How effective was the contractor in addressing E VG G F P N unforeseen or unusual customer needs and issues?

5. How satisfied were you with the contractor’s overall E VG G F P N performance?

6. If you represent a government agency, and the contract included a small business subcontracting plan, how well did the contractor adhere to the plan requirements?

E VG G F P N

Additional Comments:

PLEASE NOTE: In accordance with Federal Acquisition Regulations, contractors may be advised of adverse remarks and given an opportunity to respond. However, the contracting officer will not provide your name or copies of this questionnaire to the contractor or any other party not directly involved in the evaluation of the contractor’s proposal.

THANK YOU FOR YOUR RESPONSE