ATTACHMENT E Contractor Reference Form - 1.31.25.pdf
PDF 142 KB Posted
- Attached to
- VISN 1 Primary Reference Laboratory Testing
- Solicitation number
- 36C24124Q0194
About this file
This is a Past/Present Performance Survey form (Attachment E) designed to evaluate contractor performance for a VA laboratory testing solicitation. The form requests general information about the contractor and respondent, followed by a detailed performance evaluation using a 6-point rating scale ranging from 1 (Unsatisfactory) to 6 (Exceptional).
The evaluation criteria include initiative in problem-solving, schedule adherence, resolution of contract discrepancies, technical service quality, field service personnel performance, deficiency correction, overall contract performance, compliance with terms and conditions, and willingness to award future contracts. The form includes sections for remarks, company strengths (noting good communication and quick issue resolution), and weaknesses. Completed surveys are to be emailed to Cynthia.thompson2@va.gov. This template is associated with solicitation number 36C24124Q0194 for VISN 1 Primary Reference Laboratory Testing services.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C241Q0194 - Amendment 3 3.6.2025.pdf | ||
| 36C241Q0194 - Amendment 2 2.28.2025.pdf | ||
| 36C241Q0194 - Amendment 1_ 2.5.2025.pdf | ||
| ATTACHMENT D - QASP - VISN1 Primary Reference Lab.doc | DOC document | |
| 36C24124Q0194-Q1 - VISN 1 Primary Reference Laboratory - 1.31.25.pdf | ||
| ATTACHMENT F - Wage Determinations - 1.31.25.pdf | ||
| ATTACHMENT A- Test Menu 1.31.25.xlsx | XLSX spreadsheet | |
| ATTACHMENT C- Other Services 1.31.25.xls | XLS spreadsheet | |
| ATTACHMENT B- Facility Locations and Contacts 1.31.25.xlsx | XLSX spreadsheet |
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Text version
PRESENT/PAST PERFORMANCE SURVEY
ATTACHMENT E
A. GENERAL INFORMATION:
Solicitation Number:
Contractor's Name:
Address:
Phone:
Point of Contact:
B. RESPONDENT INFORMATION:
Name of Respondent: ________________ _Title:____ _____________
Organization:_________________________________________ __________
Address: _______________________________________________________
Telephone Number:_____________ Fax Number:_______________________
SIGNATURE:____________________________________________________
C. PLEASE EMAIL COMPLETED SURVEY FORM TO: Cynthia.thompson2@va.gov
PAST AND PRESENT PERFORMANCE SURVEY
D. PERFORMANCE INFORMATION: Choose and circle the number on the scale of 1-6 that most accurately describes the contractor's performance or situation.
CODE/PERFORMANCE LEVEL
1 UNSATISFACTORY - Performance did not meet most contractual requirement. There were serious problems and the contractor's corrective actions were ineffective.
2 MARGINAL - Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.
3 NONE - No record of past performance or the record is inconclusive.
4 SATISFACTORY - Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor was satisfactory.
5 VERY GOOD - Performance met all contract requirements and exceeded some to the Government's benefit. There were a few minor problems which the contractor resolved in a timely effective manner.
6 EXCEPTIONAL – Performance met all contract requirements and exceeded many to the government’s benefit. Problems, if any, were negligible and were resolved in a timely, highly efficient manner.
Cooperated with Government personnel after award.
(1 being Very Bad and 6 being Very Good)
1 2 3 4 5 6 N/A
Displayed initiative to solve problems.
Adherence to schedule, including the administrative aspects of performance.
Provided timely resolution of contract discrepancies
Provided timely technical service when requested.
Field service personnel are knowledgeable and professional.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
Rate the overall contractor’s performance under current or past contracts. 1 2 3 4 5 6 N/A
Contractor’s compliance with contractual terms and conditions. 1 2 3 4 5 6 N/A
Would you award another contract to this contractor? If not, explain in "remarks."
Remarks_____________________________________________________________________
Strengths of this company: The company is easy to work with. When issues did arise, Sean was willing to fix the issues quickly. Good Communication from the vendor the VA.
Weaknesses of this company:
File details come from the government source that posted it. Updated .