Attachment D - Past Performance Questionnaire.docx
DOCX document 71 KB Posted
- Attached to
- R422- HSI Participant Recruitment Federal contract opportunity
- Solicitation number
- 36C10G25Q0094
About this file
The document is a Past Performance Questionnaire (PPQ) for a Department of Veterans Affairs (VA) contract opportunity solicitation number 36C10G25Q0094. The questionnaire is designed to gather detailed performance feedback from previous clients about a contractor's performance across multiple evaluation areas, including overall quality, delivery performance, service quality, problem resolution, and personnel effectiveness. The evaluation uses a rating scale from Exceptional to Unsatisfactory and includes comprehensive questions about contract performance, terminations, option exercises, and overall contractor recommendation.
The related federal contract opportunity seeks a contractor to assist with recruitment of participants (employees, veterans, caregivers, survivors) for VA studies. The contractor will be responsible for sourcing and recruiting study participants according to specific screening criteria, performing screening, scheduling, technological assistance, note-taking, validation, and participant reimbursement. The anticipated performance period is five years with four potential one-year option years. The government will facilitate studies, and the contractor must ensure participants meet all inclusion and exclusion criteria without being provided direct access to personal information about potential participants.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| PWS Attachment D - Consent of Participants Standard Operating Procedure.pdf | ||
| Revised Attachment A - PWS HSI Participant Recruitment - Amendment 0002.pdf | ||
| Revised Attachment E - Proposal Price Template HSI Participant - Amendment 0002.xlsx | XLSX spreadsheet | |
| Attachment F - QASP_ HSI Participant.pdf | ||
| PWS Attachment A - Participant Agreement.pdf | ||
| Attachment B - All Questions and Answers.pdf | ||
| PWS Attachment C - Study Checklist.pdf | ||
| 36C10G25Q0094 Amendment 0002.pdf | ||
| PWS Attachment B - Screening Questionaire.pdf | ||
| Amendment 001 36C10G25Q0094 0001.pdf | ||
| Solicitation 36C10G25Q0094 Rev2.pdf | ||
| Solicitation 36C10G25Q0094.pdf | ||
| Attachment C - Past Performance References.pdf | ||
| Attachment B - RFQ Questions.xlsx | XLSX spreadsheet | |
| Attachment E - Proposal Price Template _HSI Participant.xlsx | XLSX spreadsheet | |
| Attachment A- PWS HSI Participant Recruitment.pdf |
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Text version
ATTACHMENT D: PAST PERFORMANCE QUESTIONNAIRE (PPQ)
AGENCY: Department of Veterans Affairs, Strategic Acquisition Center - Fredericksburg
REQUEST FOR QUOTE: 36C10G25Q0094
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 #].
Please send completed Questionnaire to E-MAIL TO:
Jessica George at Jessica.George5@va.gov AND Tawana Young at Tawana.Young@va.gov
NOTE TO OFFERORS: If the Questionnaire is provided for a subcontractor’s reference, the contractor’s name below must include both the subcontractor’s name and the offeror’s name who will be the prime contractor for this solicitation (e.g. contractor X, who will be a subcontractor to offeror Y for this solicitation).
Name of Person Completing the Evaluation:
Telephone: E-mail:
Title:
Company/Organization:
Instructions:
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.
· Exceptional: Performance that almost always exceeds the contract performance standard or requirement
· Very Good: Performance that meets and occasionally exceeds the contract performance standard or requirement.
· Satisfactory: Performance that meets the minimum contract performance standard or requirement
· Marginal: Performance occasionally does not meet minimum contract performance standard or requirement
· Unsatisfactory: Performance clearly below the contract performance standard or requirement
· Not Applicable: N/A
| Performance Areas |
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| N/A |
| 1. OVERALL QUALITY/SATISFACTION | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the overall satisfaction with the customers performance. |
| 2. DELIVERY PERFORMANCE | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the 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 | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those. |
| 4. SATISFACTION WITH PROBLEM RESOLUTION | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Comments: Assess 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 | |||||
| ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
Comments: Assess the quality of the contractor’s staff om 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 the services provided)? |
| Please provide. |
| 13. What was the dollar value of the contract performed by the contractor? |
| Please provide. |
| 14. Provide a brief description of the services provided by the contractor for this contract. |
| Please provide. |
| 15. Overall Recommendation |
| I Would |
| I Would Not |
| Given what I know today about the contractor’s ability to execute what they promised in their proposal, I would / I would not award to them today given that I had a choice. | |
| ☐ | ☐ |
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.
File details come from the government source that posted it. Updated .