Attachment - Past Performance Questionaire PPQ Attachment B.pdf
PDF 362 KB Posted
- Attached to
- Z2DA--Replace Flooring in OR, PACU, and Special Procedures Federal contract opportunity
- Solicitation number
- 36C26124R0094
About this file
This document is a Past Performance Questionnaire (PPQ) attachment for a federal contract opportunity to replace flooring in various areas of a medical facility.
The PPQ requires the contractor to provide details on at least three previous federal, state, or local government contracts completed within the last three years that are similar in scope to the current opportunity. The contractor must include information such as the contract number, type, dollar value, dates of performance, and whether they were the prime contractor. For each referenced contract, the contractor must describe the services provided, the complexity, and the percentage of work completed by the prime and subcontractors. The contractor must also indicate if there were any performance issues and how they were resolved.
The related federal contract opportunity is for Construction Services to replace flooring in the Operating Room, Post-Anesthesia Care Unit, and Special Procedures areas of a Department of Veterans Affairs medical facility. The solicitation number is 36C26124R0094, the due date for proposals is December 19, 2024 by 11:00 AM PDT, and proposals should be sent to the specified VA email addresses.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C26124R0094 0002.docx | DOCX document | |
| S04 Site Visit Sign-In 36C26124R0094.pdf | ||
| 36C26124R0094 0001.docx | DOCX document | |
| Attachment - REQUEST FOR INFORMATION RFI FORM.docx | DOCX document | |
| Attachment - PCRA 36C261-24-AP-4955.pdf | ||
| Attachment - Drawings.pdf | ||
| Attachment - Pre-Proposal Site Visit Information 36C26124R0094.pptx | PPTX presentation | |
| Attachment - VA DIRECTIVE 7715 EMR 02 FORM.pdf | ||
| Attachment - Wage Determination NV20240038 10182024.pdf | ||
| Attachment - Combined Specs 11-07-24.pdf | ||
| Attachment - Pricing Breakdown 36C26124R0094.docx | DOCX document | |
| Attachment - VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING-CERTIFICATE.pdf | ||
| Attachment - ICRA 593-19-310 unsigned draft.pdf | ||
| 36C26124R0094_1.docx | DOCX document |
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Text version
Attachment B - | Replace Flooring in Building OR, PACU, and Special Procedures
VA PAST PERFORMANCE QUESTIONNAIRE (PPQ)
INSTRUCTIONS: Offerors must identify previous federal, state, and local government contracts that they have completed and that are same (Medical Clinic Renovation) to the contract being evaluated. List at least three (3) for evaluation, limited to the last three (3) years. (One contract reference per form, the Questionnaire may be duplicated)
NOTE: If you have performed any VA Infection Control Risk Assessment Level IV contracts list them first.
Contractor (you) Information:
Name: _____________________________________________________________________
Address: ___________________________________________________________________
Telephone Number: ___________________________________________________________
E-mail: ______________________________________________________________________
Contract Information:
Name of company/agency you provided service for: ___________________________________
Contract Number: _____________________________________________________________
Type of Contract: _______________________________________________________________
Contract Dollar Value: ___________________________________________________________
Date of Award: _________________________________________________________________
Date of Completion: _____________________________________________________________
Were you the Prime Contractor: [ ] Yes or [ ] no; Credit will not be given if you were a subcontractor.
Point of Contact Information for the company/agency you serviced:
Name of the Contract Person & their position or title: ___________________________________
Address: _____________________________________________________________________
Telephone Number: _____________________________________________________________
E-mail: ________________________________________________________________________
Description of Service(s) provided, location & relevancy of work:
Complexity of Service, if any:
Percentage of Work completed by your company and by subcontractor:
Provide information on problems encountered during performance of this contract and your corrective actions, (if applicable):
What was your overall rating on this contract:
[ ] Satisfactory or above
[ ] Below Satisfactory, if below explain why:
Name of Individual completing this Info. Signature Date
(End of Questionnaire)
Internal VA Evaluation Use Only: Source Selection Technical Evaluation Board Member (SSTEB)
Information above has been verified by: __________________________/ Date: _____________________
SSTEB Chairman/Consensus: [Check & Document]
[ ] Acceptable – Pass ________________________________________________________________
[ ] Unacceptable – Fail (Reason): _______________________________________________________
File details come from the government source that posted it. Updated .