Attachment - Past Performance Questionnaire.docx

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Attached to
C1DA--EHRM Training and Support Space Design - Erie VAMC Federal contract opportunity
Solicitation number
36C77623R0041
Issued by
Department of Veterans Affairs Technology Acquisition Center Austin

About this file

This pre-solicitation notice seeks standard form SF 330 qualification packages from architecture and engineering firms for the C1DA EHRM Training and Support Space Design project located at the Erie Pennsylvania VA Medical Center. Firms should have experience in network infrastructure installation, IT room renovations, data center reconfigurations, and physical security upgrades. The project involves upgrading large-scale fiber optics, data cabling, electrical and HVAC systems. Responses are due by May 12, 2023 and will be evaluated based on professional qualifications, specialized experience, capacity, past performance, knowledge of locality, and experience in construction period services. Discussions will be held with the most highly qualified firms to be followed by a final evaluation and selection of the top-ranked firm to receive the solicitation. The anticipated period of performance for design completion is 222 calendar days from notice of award. This is a 100% SDVOSB set-aside with an estimated construction value between $1-2 million.

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Text version

ATTACHMENT 4 - PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Information

Firm Name:

Address:

Phone Number:

Point of Contact:

Contact Phone Number:

DUNs Number:

2. Work Performed as: |_| Prime Contractor |_| Sub Contractor |_| Joint Venture |_| Other

Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: |_| Firm Fixed Price |_| Cost Reimbursement |_| Other (Please specify):

Contract Title:

Contract Location:

Project Description:

Complexity of Work |_| High |_| Med |_| Routine Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT RATE ON A “+” OR “-“ SCALE. If a “+” or “-“ is used, the rating without the "+" or "-" will be applied. In addition to the ratings, please provide a short narrative in the appropriate block or in the remarks section of this form.

“O”
Outstanding
The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the offeror were highly effective.
“A”
Above Average
The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the offeror were effective.
“S”
Satisfactory
The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the offeror were satisfactory.
“M”
Marginal
Performance did not meet some contractual requirements. Performance indicated that there are some potential risks associated with the quality products, timeliness of service, and contract performance.
“U”
Unacceptable
Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the offeror has yet to identify corrective actions or the offeror’s proposed actions appear only marginally effective or were not fully implemented.

Please rate and provide any supporting information/comments for the following:

1. The quality of the working relationship with the client (the tenant and/ or owner).
O A S M U
2. The professionalism and integrity with which offeror conducted business.
O A S M U

3. The responsiveness to the client’s needs and expectations.

O A S M U

4. The Offeror’s ability to successfully management and perform the project.
O A S M U
5. The offeror’s level of communication.
O A S M U
6. The quality control of the project.
O A S M U

7. Any Value added to the project as the result of cost savings, favorable financing, positive asset management, etc.

Yes No

8. Would you award another contact to the party being evaluated? If no, please explain.
Yes No
9. The delivery of the project within the budget and on schedule.
O A S M U

10. Other relevant aspects in the management of a project development for the client.

11. Overall rating for this firm:
O A S M U

Signature of Evaluator

Date

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