Attachment D- Past Performance Questionnaire.docx
DOCX document 52 KB Posted
- Attached to
- R408--DHO, Interoperability Pledge Program Support (Convener) Federal contract opportunity
- Solicitation number
- 36C10G25R0026
About this file
This document is a Past Performance Questionnaire (PPQ) for a Department of Veterans Affairs (VA) contract solicitation (RFP 36C10G25R0026) for the Interoperability Pledge Program Support. The PPQ is a detailed evaluation form designed to capture reference information about a contractor's past performance across multiple performance areas, including overall quality, delivery performance, service quality, problem resolution, and personnel quality.
The solicitation has a tiered evaluation approach prioritizing socioeconomic business categories: Tier 1 (Service-Disabled Veteran-Owned and Veteran-Owned Small Businesses), Tier 2 (8(a) and HUBZone Small Businesses), Tier 3 (Women-Owned Small Businesses), and Tier 4 (Other than Small Businesses). The contract is for Administrative Management and General Management Consulting Services (NAICS 541611) with a total five-year period of performance, anticipated to begin around September 30, 2025. A Business Associate Agreement is required for handling Protected Health Information, and offerors must submit questions through a specified process outlined in Attachment B of the RFP.
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Text version
ATTACHMENT D: PAST PERFORMANCE QUESTIONNAIRE (PPQ)
AGENCY: Department of Veterans Affairs, Strategic Acquisition Center - Fredericksburg
REQUEST FOR PROPOSAL: 36C10G25R0026
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:
Kristal Hall at kristal.hall@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.
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