ATTACHMENT F - PAST PERFORMANCE QUESTIONAIRE.docx

DOCX document 21 KB Posted

Attached to
J056--Correct Fire (Life) Safety Issues (Construction)
Solicitation number
36C24626R0078
Issued by

About this file

This is a Past Performance Questionnaire form that serves as a corporate experience evaluation document for the Department of Veterans Affairs solicitation J056—Correct Fire (Life) Safety Issues (Construction).

Offerors must submit between three and five examples of completed or in-progress contracts of similar size and scope, with each project exceeding a minimum threshold value of $1,000,000. For each contract example, offerors must provide comprehensive information including: customer/company name and address, point of contact details (name, title, email, and phone number), contract value, contract term dates, contract effective date, current contract status (ongoing or completed), and a detailed description of the scope of work performed. The form is structured to accommodate up to five contract examples listed in reverse chronological order, with additional space available for detailed scope descriptions. This documentation will be evaluated under the Technical Capability Sub-Factor 2—Corporate Experience as part of the overall proposal assessment for this VA construction solicitation addressing fire and life safety corrections.

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ATTACHMENT B: CORPORATE EXPERIENCE FORM

Please list your contracts in chronological order beginning with the most recent one. Offerors must provide a minimum of three (3) and a maximum of five (5) examples of their choice of completed projects or in progress of similar contracts in size and scope with a minimum threshold value exceeding $1,000,000. See Technical Capability Sub-Factor 2 – Corporate Experience for all required information to be included.

Contract #1

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status ___Ongoing ___Completed

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #2

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #3

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #4

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

Contract #5

1.Customer/Company Name
2. Customer’s Address
3.Name and Title of Point of Contact
4.Point of Contact’s Email Address
5.Point of Contact’s Phone Number
6.Contract Value

7. Contract Term (Month and Year)

From _______ through _______________

8. Contract Effective Date

9. Contract Status

10. Scope of Contract Requirements (Describe in detail the scope of works performed under this contract as indicated in the Solicitation documents. Attach separate sheet if additional space is needed.)

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