The file is a Past Performance Questionnaire for an Indian Health Service (IHS) solicitation for a Multiple Award Indefinite Delivery/Indefinite Quantity (ID/IQ) contract for Non-Personal Healthcare Services. The solicitation (No. 75H71025R00006) seeks Psychiatrist, Psychologist, and Licensed Clinical Social Worker services for three Navajo Area Service Units: Gallup, Shiprock, and Crownpoint.
The questionnaire provides a detailed rating system with performance levels ranging from Exceptional (E) to Unsatisfactory (U), covering areas such as service quality, cost control, timeliness, special needs management, subcontractor integration, and overall performance. The document includes specific submission instructions, requiring the completed questionnaire to be emailed to Misty Billy at Misty.Billy@ihs.gov by November 18, 2025, at 1:00 pm MST. Proposal submissions are due by 3:00 pm on the same date, with questions accepted until November 3, 2025, at 1:00 pm MST.
The file's text, extracted by GovTribe without its formatting.
Sheet1
Past Performance Reference Questionnaire
Indian Health Service, Navajo Area
Solicitation No.
75H71025R00006
Title:
Multiple Award ID/IQ for Non-Personal Healthcare Psychiatrist, Psychologist and Licensed Clinical Social Worker Services for Navajo Area
Header section to be completed by the Offeror and provided to the reference with instructions to submit the completed questionnaire directly to the Government contact identified in Section IV.
Contractor:
Contract No.:
Contract Name:
Rater Name:
Rater Phone No.:
Rater E-mail Address:
Rater's Role in Relation to the Contract:
Rating Definitions
Rating
Definition
Note
E - Exceptional
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.
VG - Very Good
Performance met contractual requirements and exceeded some to the government’s benefit. The contractual performance of the element or subelement 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.
S - Satisfactory
Performance met contractual requirements. The contractual performance of the element or subelement 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.
M - Marginal
Performance did not meet some contractual requirements. The contractual performance of the element or subelement 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).
U - Unsatisfactory
Performance did not meet most contractual requirements and recovery was not accomplished in a timely manner. The contractual performance of the element or subelement contained a serious problem(s) for which the contractor’s corrective actions were ineffective.
To justify an “unsatisfactory” rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it affected the government. A singular problem, however, could be of such serious magnitude that it alone merits an “unsatisfactory” rating. An “unsatisfactory” rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency report or letter).
Index
Section I - Ratings
Section II - Additional Narrative Justification
Section III - Signature of Rater
Section IV - Return Instructions
Section V - Contact Information
Please provide any relevant information to support the above ratings.
Section 1 - Ratings
Contractor Performance:
E
VG
S
M
U
N/A
How would you rate the quality of the Contractor's products/services provided?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the Contractor's ability to control costs?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the Contractor's timeliness of the products/services delivered?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the Contractor's ability to meet special needs (such as expidited delivery or crisis support ) for delivery requirements?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the Contractor's ability to effectively manage, coordinate and integrate subcontractors?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the Contractor's performance on small business subcontracting?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate the performance of the Contractor's warranty/maintenance?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
How would you rate your overall satisfaction with the Contractor's performance?
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
Supporting Narrative:
Section II - Additional Narrative Justification
Additional narrative justification, if required - Include the number of the question (from above) which this supporting narrative applies.
Section III - Signature of Rater
Signature of Rater:
Date:
Section IV - Return Instructions
Return the completed questionnaire via email to Misty.Billy@ihs.gov by November 18, 2025 @ 1:00 pm MST.
Section V - Contact Information
For any questions pertaining to the questionnaire, contact Misty Billy at Misty.Billy@ihs.gov.
File details come from the government source that posted it.
Updated .
