ATTACHMENT D_PAST PERFORMANCE QUESTIONAIRRE.docx

DOCX document 19 KB Posted

Attached to
J059--AITC Electrical Maintenance Services (VA-20-00049479)
Solicitation number
36C10X20Q0132
Issued by

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This document contains a past performance questionnaire for a contractor bidding on an electrical maintenance services contract for the Department of Veterans Affairs. The contractor is asked to provide the questionnaire to a past client for feedback on their performance on a previous contract. The past client is asked to rate the contractor's overall quality, delivery performance, quality of service, problem resolution ability, and personnel quality on a scale of 1 to 5, with 1 being below standards and 5 exceeding standards. Additional questions address issues like cure notices, terminations, willingness to award another contract, opportunities to comment on past performance, and past performance reporting. The client is also asked to provide the contract period of performance, dollar value, and brief description of services previously provided. Relevant attachments can also be included to aid the evaluation.

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Other files

File Type Posted
36C10X20Q0132 0001.docx DOCX document
36C10X20Q0132 0001_1.pdf PDF
ATTACHMENT A_Example Job Safety Risk Assessment.docx DOCX document
ATTACHMENT C_PAST PEFORMANCE REFERENCES.pdf PDF
36C10X20Q0132_2.docx DOCX document
ATTACHMENT B _Wage Determination.pdf PDF

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ATTACHMENT D: PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Request for Proposal (RFP) No.: 36C10X20Q0132 Title: AITC Electrical Maintenance

TO: Tara Flores, Contracting OfficerAGENCY: VA, SAC-F
PHONE: 240-215-1644E-MAIL: Tara.Flores@va.gov

INFORMATION REQUEST: PAST PERFORMANCE

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

Send completed questionnaires to Tara.Flores@va.gov and Riley.Bender@va.gov

NOTE TO OFFERORS: If the Questionnaire 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.

· Not Applicable: N/A

· 1: Performance clearly below the contract performance standard or requirement

· 2:Performance occasionally does not meet minimum contract performance standard or requirement
· 3:Performance that meets the minimum contract performance standard or requirement
· 4:Performance that meets and occasionally exceeds the contract performance standard or requirement
· 5:Performance that almost always exceeds the contract performance standard or requirement
1. Overall quality/satisfaction
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Overall satisfaction with the Contractor’s performance.

2. Delivery performance
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.

3. Satisfaction with the quality of service delivered
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.

4. Satisfaction with problem resolution
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

This includes the contractor’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.

5. Satisfaction with the quality of contractor personnel
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Rate the quality of the contractor’s staff in executing the project work scope.

6. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years?

|_| Yes |_| No If Yes, please explain.

7. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.

8. Based on the contractor’s overall performance, would you award them another contract?

|_| Yes |_| No If No, please explain.

9. Have you discussed any adverse past performance problems with the Contractor and given them an opportunity to comment? |_| Yes |_| No Please explain.

10. Do you file past performance information in a database that the Contracting Officer may search?|_| Yes |_| No Please explain.

11. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.

12. What was the contract period of performance (i.e., when were services provided)?

13. What was the dollar value of the contract performed by the contractor?

14. Provide a brief description of the services provided by the contractor for this contract.

Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Contractor’s past performance by the evaluator. Please provide information on any adverse performance by the contractor and the corrective actions taken.

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