attachment E Past Performance Questionnaire.pdf

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Attached to
Z1DA--FY22 Tier 2: NRM (PROJ: 548-22-140) DB Upgrade CLC Hospice Outbuildings Transformer
Solicitation number
36C24822R0082
Issued by

About this file

This document contains a past performance questionnaire and details of a related federal contract opportunity. The past performance questionnaire is to be completed by a referenced client for a contractor's previous work. It includes eight questions rating various aspects of the contractor's performance on a scale of Outstanding, Good, Satisfactory, Marginal, Unsatisfactory or Neutral.

The related federal contract opportunity is for installing a new 750 KVA transformer at the Dayton VA Medical Center. The transformer will feed the main electrical room and additional buildings on site, including a community living center, VA police building, HR building, water tower pump house, hospice building and Fisher House. The work must be completed by the response due date of the solicitation issued by the Department of Veterans Affairs Veterans Health Administration VISN 8.

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Other files

File Type Posted
Sequence of Operation.pdf PDF
Distribution Drawings.pdf PDF
36C24822R0082 0003.docx DOCX document
Building 3 CLC - 3-P3.pdf PDF
NURSINGHOMEA.doc DOC document
NURSINGHOMEATS131416.doc DOC document
3-W1.jpg JPG image
Schematic Diagram 6336S01.pdf PDF
3-W2.pdf PDF
Building 3 CLC - 3-E2.pdf PDF
548.CS103.16.EI601.pdf PDF
Schematic Diagram F529S01.pdf PDF
Schematic Diagram 6336S01 with notes.pdf PDF
36C24822R0082 0002.docx DOCX document
Site Visit Sign-in Sheet.pdf PDF
36C24822R0082 0001.docx DOCX document
36C24822R0082_2.docx DOCX document
05 VA 01 00 00 GENERAL REQUIREMENTS.docx DOCX document
000110 Master Specification Index.pdf PDF
26 12 19 Pad Mounted Liquid Filled Medium Voltage Transformer.docx DOCX document
Design Manual Index.pdf PDF
Attachment f Project Price Breakdown.xlsx XLSX spreadsheet
07 Specification VA 01 32 17 Project Schedules.doc DOC document
09 548-21-102 Contractor Trade.docx DOCX document
fl220WD.docx DOCX document
548-22-140 Location Plan.pdf PDF
Upgrade CLC and Outbuildings - Drawing.pdf PDF
548-22-140 Site Plan.pdf PDF
36C24822R0082_2.docx DOCX document
06 Specification VA 01 42 19 Reference Standards 02.docx DOCX document
08 548-21-102 013323 Shop Drawings Product Data and Samples.docx DOCX document
06 Specification VA 01 42 19 Reference Standards.docx DOCX document
attachment D Experience Information Sheet.pdf PDF
3-E16 Marked Up.pdf PDF
attachment C Contractor Safety and Environmental Record Form 02.pdf PDF
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1. Concerning performance, how would you rate the contractor’s adherence to technical requirements of the contract? O G S M U N

COMMENTS/REMARKS:

2. How would you rate the contractor’s performance in completing the project in accordance with planned progress schedule? (Note – Notwithstanding changes that are legitimate to extend performance.

O G S M U N

COMMENTS/REMARKS:

Attachment E

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY REFERENCED CLIENT: Please return this completed questionnaire via e-mail to Stacy Figlinski, the requesting Contracting Officer at the following email addresses: Stacy.Figlinski@va.gov.

No later than 5 calendar days prior to RFP closing date. Performance definitions are found on page 4 of this document.

Note: When sending back to Contracting Officer by email – ensure the following: Ensure Email Subject line is as follows: (Solicitation #) , Company Name

Contract Number:

Project Title:

Contract Amount:

Contract Completion Date:

Contractor:

Rating scale is as follows: O=Outstanding, G=Good, S=Satisfactory, M=Marginal, U=Unsatisfactory, N=Neutral The full rating definitions are listed after the questionnaire for reference.

3. How would you rate the contractor’s timeliness of Material Submittals, Payrolls, Quality Control Plan, Safety Plans etc.? O G S M U N

COMMENTS/REMARKS:

4. How would you rate the contractor submissions of change orders in terms of the number submitted and purpose? O G S M U N

COMMENTS/REMARKS:

5. How was the Project Management Teams effectiveness? (to include use and control of subcontractors)

O G S M U N

COMMENTS/REMARKS:

6. How was the contractor’s team and rate how well they accomplished the project (to include use and control of subcontractors)

O G S M U N

COMMENTS/REMARKS:

7. Would you hire this contractor again?

COMMENTS/REMARKS:

Yes No

8. How would you rate the contractor’s OVERALL PERFORMANCE?

O G S M U N

COMMENTS/REMARKS:

Signature of Rater: ____________________________________ Date: ________________

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Adjective Past performance definition

(O) Outstanding The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded many to the government’s benefit. The company performed with very few or very minor problems, for which corrective actions taken were, or are expected to be, highly effective. Performance of completed contracts was either consistently of the highest quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an extremely strong expectation of successful performance.

(G) Good The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded some to the government’s benefit. The company performed with some minor problems, for which corrective actions taken were, or are expected to be, effective. Performance of completed contracts was either consistently of high quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to a strong expectation of successful performance.

(S) Satisfactory The offeror’s performance of previously awarded relevant contracts met contractual requirements. The company performed with some problems, for which corrective actions taken by the contractor were, or are expected to be, effective. Performance of completed contracts was consistently of adequate or better quality or exhibited a trend. The offeror’s past performance record leads to an expectation of successful performance.

(M) Marginal The offeror’s performance of previously awarded relevant contracts did not meet some contractual requirements. The contractor’s performance reflected some serious problems, performance reflected some serious problems, for which the contractor either failed to identify or implemented corrective actions in a timely manner, or for which the corrective actions implemented or proposed to be implemented were, or are expected to be, only partially effective. Performance of completed contracts was consistently of mediocre quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an expectation that successful performance might be difficult to achieve or that it can occur only with increased levels of government management and over sight.

(U) Unsatisfactory

The offeror’s performance of previously awarded relevant contracts did not meet contractual requirements, and recovery, if any, did not occur within the period of performance. The contractor’s performance reflected serious problems for which the offeror either failed to identify or implement corrective actions were mostly ineffective.

Performance of completed contracts was consistently of poor quality or exhibited a trend toward becoming so. The offeror’s past performance will not be achieved or that it can occur only with greatly increased levels of government management and oversight.

(N) Neutral The offeror lacks a record of relevant or available past performance history. Based on this, there is no expectation of either successful or unsuccessful performance.

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