ATTACHMENT G - PAST PERFORMANCE QUESTIONAIRE - NX EQ STRETCHERS.docx
DOCX document 19 KB Posted
- Attached to
- 6515--NX EQ STRETCHERS
- Solicitation number
- 36C10G22R0009
About this file
This combined synopsis and solicitation seeks proposals for Stryker brand name or equal stretchers and related equipment to be used by clinicians throughout Department of Veterans Affairs medical centers and facilities. Key requirements include Stryker Prime SeriesA stretchers or equivalent products meeting all salient characteristics such as accommodating a minimum 700-pound weight capacity, head and foot elevation capability of greater than 69 degrees, and integrated braking, oxygen holder, and utility systems. Proposals are due by June 27, 2022, and the period of performance is one base year with four one-year options. Offerors must demonstrate in their technical proposals that products meet all salient characteristics, and all proposed items must be included in the pricing volume with quantities. The requirement will be fulfilled through a single-award requirements contract to provide stretchers critical for securely transporting patients.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT E - REPORTING TOOL - NX EQ STRETCHERS.xlsx | XLSX spreadsheet | |
| ATTACHMENT C - SOLICITATION CLAUSES - NX EQ STRETCHERS.docx | DOCX document | |
| ATTACHMENT D - SOLICITATION PROVISIONS - NX EQ STRETCHERS.docx | DOCX document | |
| ATTACHMENT F - PAST PERFORMANCE REFERENCES - NX EQ STRETCHERS.pdf | ||
| ATTACHMENT A - PRICE COST SCHEDULE - NX EQ STRETCHERS.xlsx | XLSX spreadsheet | |
| ATTACHMENT B - CONTRACT ADMINISTRATION - NX EQ STRETCHERS.docx | DOCX document | |
| 36C10G22R0009.docx | DOCX document |
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Text version
Attachment G Past Performance Questionnaire
SOLICITATION NO.: 36C10G22R0009
DESCRIPTION: NX EQ Stretchers - Stryker Brand Name or Equal
Offerors: Please Send to Each Reference Cited in Submitted Proposal (Maximum of Five References from Past Three Years)
DEPARTMENT OF VETERANS AFFAIRS (VA)
STRATEGIC ACQUISITION CENTER (SAC)
PAST PERFORMANCE QUESTIONNAIRE
TO: Ninatile Bacote E-MAIL: Ninatile.Bacote@va.gov
VA SAC is currently in the process of awarding a contract for the solicitation described above. The offeror identified below has provided your organization’s name as a reference under the contract described below:
Offeror Name:
(Insert Offeror’s Name Here)
| Contract Number: |
| (Insert Applicable Contract Number Here) |
Please rate the offeror in each of the categories on this questionnaire. See “Rating Guidelines” section for detailed description of categories and ratings. There is room for comments where you deem remarks would be helpful to our evaluation (see ‘Comment from Reference’ under “Offeror Evaluation.” Please note that the past performance evaluators for this solicitation may contact you for further details in making a fair assessment of this offeror’s past performance. Thank you for your organization’s assistance in fairly evaluating offeror proposals for this solicitation.
Please E-mail Questionnaire to Ninatile.Bacote@va.gov by June 27, 2022, at 11:59 PM EST._
| Name of Reference: |
| (Reference Complete These Sections) |
Title of Reference:
Phone Number:
E-Mail Address:
Name of Organization:
Contract Period of Performance (Month/Day/Year Begin and End):
Total Contract Value (Base and All Option Years):
Options Exercised on Contract (Yes/No)?
Brief Description of Services/Commodity Provided by Offeror:
Show Cause Order Issued on Contract (Yes/No)?
Stop Work Order Issued on Contract (Yes/No)?
Termination for Convenience, Cause, or Default Issued on Contract (Yes/No)?
Rating Guidelines:
| Rating |
| Quality of Service |
| Cost Control |
| Timeliness of Performance |
| Business Relations |
| 1: Unsatisfactory |
| Offeror is not in compliance and has jeopardized achievement of contract objectives |
| Offeror is unable to manage costs effectively |
| Offeror delays have jeopardized performance |
| Responses to inquiries and issues are not effective |
| 2: Satisfactory |
| Minor inefficiencies and errors have been identified |
| Offeror is usually effective in managing costs |
| Offeror is usually effective in meeting milestones and delivery schedule |
| Responses to inquiries and issues is usually effective |
| 3: Excellent |
| Offeror is in compliance with contract requirements and delivers quality services |
| Offeror is effective in managing costs and submits proper invoices |
| Offeror is effective in meeting and exceeding milestones and delivery schedule |
| Responses to inquiries have been effective and/or exceeded expectations and established deadlines |
Offeror Evaluation:
| Rating (List Number Based on Rating Guidelines Above) |
| Category |
| Description |
| Quality of Service |
| In compliance with contract requirements, submits accurate reports/deliverables, has effective personnel, and has achieved/maintained technical excellence: |
Comment from Reference: _______________________
| Cost Control |
| Has achieved efficiencies in costs, managed costs effectively, and has submitted timely/accurate invoices with supporting documentation: |
| Timeliness of Performance |
| Has met milestones, is reliable, is responsive to technical direction, and has completed milestones on-time or ahead of schedule: |
| Business Relations |
| Has maintained effective management of contract, has exhibited reasonable/cooperative behavior, is responsive to contract requirements, is responsive to inquiries/issues, and is proactive about resolving problems: |
| |_| YES |_| NO |
| Overall Satisfaction |
| Would you (reference) choose to work with this offeror again? |
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