D.3 ATTACHMENT C 36C10X22R0060.docx

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Attached to
DK10--Police Body Worn and Vehicle Mounted Camera and Digital Evidence Management System
Solicitation number
36C10X22R0060
Issued by

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This document contains a past performance questionnaire for a federal solicitation. The Department of Veterans Affairs Strategic Acquisition Center Frederick is seeking a contractor to provide police body worn and vehicle mounted cameras and a digital evidence management system. Respondents are asked to evaluate an incumbent contractor's past performance on a previous contract by rating quality, schedule, cost control, management, small business utilization, and regulatory compliance on a scale from exceptional to unsatisfactory. Additional questions inquire about the previous contract's period of performance, dollar value, and services provided. The overall recommendation question asks if the respondent would award a contract to the incumbent today based on their proposal and performance.

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D.3 ATTACHMENT C - PAST PERFORMANCE QUESTIONNAIRE (PPQ)

AGENCY: Department of Veterans Affairs, Strategic Acquisition Center - Frederick

RFQ: 36C10X22R0060, VA POLICE BODY WORN CAMERAS

TO: Carey M. Kauzlarich

INFORMATION REQUEST: PAST PERFORMANCE

The Department of Veterans Affairs is currently in the process of awarding a competitive service contract [CONTRACTOR NAME] has provided this Questionnaire to you for a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT #].

Please send completed questionnaires to Brian.Ballard@va.gov AND Carey.Kauzlarich@va.gov.

NOTE TO RESPONDENTS: If the Questionnaire is provided for a subcontractor’s reference, the contractor’s name below must include both the subcontractor’s name and the offeror’s name who will be the prime contractor for this solicitation (e.g. contractor X, who will be a subcontractor to offeror Y for this solicitation).

Vendor’s Name:

Name of Person Completing the Evaluation:

Telephone: E-mail:

Title:

Company/Organization:

Instructions:

Please rate the vendor in each of the following areas. Note: there is room for comments where you deem remarks would be helpful to our evaluation.

· Exceptional: Performance that almost always exceeds the contract performance standard or requirement

· Very Good: Performance that meets and occasionally exceeds the contract performance standard or requirement

· Satisfactory: Performance that meets the minimum contract performance standard or requirement

· Marginal: Performance occasionally does not meet minimum contract performance standard or requirement

· Unsatisfactory: Performance clearly below the contract performance standard or requirement

· Not Applicable: N/A

Performance Areas
Exceptional
Very Good
Satisfactory
Marginal
Unsatisfactory
N/A
1. QUALITY
☐☐☐☐☐☐
Comments: Assess the achieved service performance relative to performance parameters required by the contract or order.
2. SCHEDULE
☐☐☐☐☐☐
Comments: Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance).
3. COST CONTROL (Not required for Fixed Price type contracts or orders)
☐☐☐☐☐☐
Comments: Assess the Contractor’s effectiveness in forecasting, managing, and controlling contract or order cost.
4. MANAGEMENT
☐☐☐☐☐☐
Comments: Assess the integration and coordination of all activity needed to execute the contract or order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.
5. UTILIZATION OF SMALL BUSINESS
☐☐☐☐☐☐
Comments: Assess compliance with all terms and conditions in the contract or order relating to Small Business participation (including FAR 52.219-8 Utilization of Small Businesses, and FAR 52.219-9 Small Business ☐Subcontracting Plan, when required).
6. REGULATORY COMPLIANCE
☐☐☐☐☐☐
Comments: E.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments. Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes, using the Evaluation Ratings Definitions.

7. What was the contract period of performance (i.e., when were services provided)?

8. What was the dollar value of the contract performed by the vendor?

9. Provide a brief description of the services provided by the vendor for this contract.

10. Overall Recommendation
Would
Would Not
Signed
Given what I know today about the contractor’s ability to execute what he promised in his proposal, I _________________ award to him today given that I had a choice.
☐☐

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