Attch 1 - Past Performance Survey.pdf
PDF 155 KB Posted
- Attached to
- Hoptel - Lake City
- Solicitation number
- 36C24822Q0203
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Text version
36C24822Q0203 Hoptel - Lake City
Past Performance Survey Offeror Name: ________________
OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be included with the offeror’s technical proposal.
EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the Offeror listed above for award of a VA contract. Your comments would be appreciated regarding this firm’s past performance. Your comments are considered Source Selection Sensitive. Under Federal Acquisition Regulation Part 15.506, the name of the individuals providing reference information is confidential and will not be released or made publicly available.
Name of Company being evaluated:
Evaluator’s Name:
Evaluator’s Company Name, Address and Phone number:
What contracts did this offeror perform for your company? Provide the total contract amount, dates of performance, and contract number.
Evaluation Questions Comment on the overall quality of contractor’s work.
Were there any performance issues/concerns? If so, how were they handled?
If any changes were needed, was the contractor flexible in responding to those changes?
Signature Date:
| Offeror Name: |
| Name of Company being evaluated: |
| Evaluators Name: |
| Evaluators Company Name Address and Phone number: |
| What contracts did this offeror perform for your company Provide the total contract amount dates of performance and contract number: |
| Comment on the overall quality of contractors work: |
| Were there any performance issuesconcerns If so how were they handled: |
| If any changes were needed was the contractor flexible in responding to those changes: |
| Signature: |
| Date: |
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