D.3 ATTACHMENT 3 PAST PERFORMANCE SURVEY.docx
DOCX document 16 KB Posted
- Attached to
- J036--MOD 0002 Replace Updated PWS This is for a Base Year plus 3 one-year Option periods
- Solicitation number
- 36C26125Q0697
About this file
This document is a Past Performance Survey form for a Department of Veterans Affairs contract (Solicitation Number 36C26125Q0697) related to Emergency Generator and ATS PM Services for VAPIHCS. The survey is designed to collect reference information from previous contractors who have worked with the company being evaluated. The form requires evaluators to provide details about services rendered, including contract performance dates, total contract amounts, contract numbers, and a qualitative assessment of the contractor's performance using a rating scale from Excellent to Unacceptable. Key evaluation questions focus on overall work quality, performance issues, contract execution, and the contractor's ability to manage and resolve challenges during the project.
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Other files
| File | Type | Posted |
|---|---|---|
| UPDATED B.3 PERFORMANCE WORK STATEMENT - ATS PM Generators.pdf | ||
| 36C26125Q0697 0002_1.docx | DOCX document | |
| MOD 36C26125Q0697 0001.pdf | ||
| 36C26125Q0697 0001_1.docx | DOCX document | |
| S02 RFQ 36C26125Q0697 - PM Generators - 459.pdf | ||
| D.1 ATTACHMENT 1 QUALITY ASSURANCE SURVEILLANCE PLAN.doc.docx | DOCX document | |
| D.2 ATTACHMENT 2 DOL WAGE DETERMINATION 2015-5689 REV.25, DATED 06-02-2025 - HAWAII.pdf | ||
| 36C26125Q0697_1.docx | DOCX document |
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Text version
Past Performance Survey 36C26126Q0697
OFFEROR INSTRUCTIONS: A separate survey must be completed and signed for each reference. The completed surveys must be submitted directly to durell.salaz@va.gov.
EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the company listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. The name of the individuals providing reference information is confidential and will not be released or made publicly available.
Please Note: When completing this Survey be sure to summarize what service(s) you provided on the contract(s) to include the performance dates, dollar amount(s) and contract number(s).
Name of Company being evaluated:
Evaluator’s Name and signature: Must be signed
Evaluator’s Company Name, Address and Phone number:
Indicate what services did this company provided for you? Provide the total contract amount, dates of performance, and contract number.
Evaluation Questions
Please rate the overall quality of work using a scale of (Excellent, Good, Fair, Marginal, Unacceptable). Comments in support of the rating are welcome.
Were there any performance issues/concerns? If so, how were they handled?
How did the Contractor perform on the contract?
Were there any issues and how did they handle them?
File details come from the government source that posted it. Updated .