ATTACHMENT E PAST PERFORMANCE QUESTIONNAIRE.docx

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Attached to
J046--FY22: Reverse Osmosis Water System Maintenance
Solicitation number
36C24822Q0751
Issued by

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This document contains a past performance questionnaire template for the solicitation number 36C24822Q0751 seeking reverse osmosis water system maintenance services. The questionnaire is to be completed by a reference for the offeror and addresses the offeror's performance on reverse osmosis maintenance contracts. Specific rating criteria include quality of services, cost control, timeliness, ability to meet special needs, subcontractor management, small business subcontracting, and warranty/maintenance performance. References are instructed to return the completed questionnaire to the contracting officer at the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8 by July 19, 2022.

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File Type Posted
ATTACHMENT H MAINTENANCE SCHEDULE AMENDMENT 0001.xlsx XLSX spreadsheet
ATTACHMENT F GOVERNMENT RESPONSE AMENDMENT 0001.docx DOCX document
36C24822Q0751 0001.docx DOCX document
ATTACHMENT G PRICE COST SCHEDULE AMENDMENT 0001.docx DOCX document
ATTACHMENT D CONTRACTOR REQUEST FOR INFORMATION.docx DOCX document
ATTACHMENT C AAMI TIR34 2014 r2017.pdf PDF
36C24822Q0751_1.docx DOCX document
WAGE DETERMINATION.docx DOCX document
ATTACHMENT B MAINTENANCE SCHEDULE.xlsx XLSX spreadsheet

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ATTACHMENT E

PAST PERFORMANCE QUESTIONNAIRE

RFQ 36C24822Q0751, Reverse Osmosis Maintenance

Section I is to be completed by the offeror and provide to their reference with instructions to complete Section II through IV and submit to the Contracting Officer prior to the offer due date/local time at block 8 of the SF1449. Contractor shall submit a completed copy of section I with their quote.

SECTION I:

Contractor:

Contractor DUNS:

Contract Number:

Contract Title:

Rater Name:

Rater Telephone:

Rater E-Mail Address:

Rater’s Role in Relation to the Contract (program/project manager, contracting officer, major end user)

INDEX

Section I – Contractor Section II – Ratings Section III – Additional Narrative Justification Section IV – Signature of Rater Section V – Return Instructions Section VI – Rating Definitions

SECTION II-RATINGS
Select a Rating Category

Contractor Performance

1. How would you rate the quality of the contractor’s services to provide reverse osmosis maintenance?

Supporting narrative: see rating definitions

Choose an item.

2. How would you rate the contractor’s ability to control costs?

Choose an item.

3. How would you rate the contractor’s timeliness of the services being performed?

Supporting narrative: see rating definitions

Choose an item.

4. How would you rate the contractor’s ability to meet special needs (such as expedited services or emergency support)?

Supporting narrative: see rating definitions

Choose an item.

5. How would you rate the contractor’s ability to effectively manage, coordinate, and integrate subcontractors?

Supporting narrative: see rating definitions

Choose an item.

6. How would you rate the contractor’s performance on small business subcontracting?

Supporting narrative: see rating definitions

Choose an item.

7. How would you rate the performance of the contractor’s warranty/maintenance?

Supporting narrative: see rating definitions

Choose an item.

8. How would you rate your overall satisfaction with the contractor’s performance?

Choose an item.

SECTION III – Additional Supporting Narrative, if required.

Include the number of the question above to which this supporting narrative applies.

SECTION IV – Signature of Rater

Rater Name:

Signature of rater: _______________________________________ Date: __________________________________________________ Signature of rater is not required if sent via e-mail directly from rater.

SECTION V – Return Instructions

Return the completed questionnaire via e-mail to: rohan.mckenzie@va.gov. no later than 4:00PM, July 19, 2022, EASTERN DAYLIGHT TIME (EDT).

SECTION VI – Rating Definitions

Rating
Definition
Note

Exceptional (E)

Performance met contractual requirements and exceeded many to the government’s benefit. The contractual performance of the element or sub element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
To justify an “exceptional” rating, identify multiple significant events and state how they were of benefit to the government. A singular benefit, however, could be of such magnitude that it alone merits an “exceptional” rating. Also, there should have been no significant weaknesses identified.

Very Good

(VG)

Performance met contractual requirements and exceeded some to the government’s benefit. The contractual performance of the element or sub element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
To justify a “very good” rating, identify a significant event and state how it was a benefit to the government. There should have been no significant weaknesses identified.

Satisfactory (S)

Performance met contractual requirements. The contractual performance of the element or sub element contained some minor problems for which corrective actions taken by the contractor appeared to be or were satisfactory.
To justify a “satisfactory” rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been no significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than “satisfactory” solely for not performing beyond the requirements of the contract/order.

Marginal (M)

Performance did not meet some contractual requirements. The contractual performance of the element or sub element being evaluated reflected a serious problem for which the contractor did not identify corrective actions. The contractor’s proposed actions were only marginally effective or were not fully implemented.
To justify a “marginal” performance rating, identify a significant event in each category that the contractor had trouble overcoming and state how it affected the government. A “marginal” rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

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