D.3 Past Peformance Contacts.docx
DOCX document 39 KB Posted
- Attached to
- Pharmacy Compounded Sterile Preparation (CSP) VISN 15 Federal contract opportunity
- Solicitation number
- 36C25526R0023
About this file
This is a Performance Risk Assessment Questionnaire template for past performance evaluation of potential contractors. Offerors responding to Solicitation 36C25526R0023 for Pharmacy Compounded Sterile Preparation services with the VA Heartland Health Care Network (VISN 15) must provide this form to a minimum of three current or past performance references who have firsthand knowledge of the contractor's work on compounding services conducted within the past three years. References must complete and return the questionnaire directly to Maria Riza R. Owen, Contract Specialist at maria.owen2@va.gov, with the solicitation number and "Past Performance Questionnaire" in the email subject line. All questionnaires must be received by the solicitation due date identified in SF 1449, block 8, unless extended via amendment; questionnaires submitted by the offeror will not be considered.
The questionnaire evaluates contractor performance across five primary categories using a 1-6 scale with risk level designations: Quality of Product or Service (conformance to specifications, report accuracy, personnel qualifications, subcontractor management); Price Control (cost performance and invoice timeliness); Timeliness/Schedule (task completion and responsiveness); Business Relationships (management effectiveness, communication, and issue resolution); and Key Personnel (qualification and availability). Additionally, the form requests yes/no responses regarding willingness to award another contract, contract terminations for default, cure notices or suspension of payments, and an overall performance rating. Comments are mandatory for any Exceptional, Marginal, Very Good, or Unsatisfactory ratings.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| D.1 Summary of Services.xlsx | XLSX spreadsheet | |
| D.2 VHA PBM.pdf | ||
| 36C25526R0023_VISN15 Compounding Services_final.pdf |
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Text version
PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE
Past Performance Survey
The Offeror is to provide this form to a minimum of three (3) current/past performance references for Compounding Services conducted within the past three years, to include the names and phone numbers of responsible individuals who would have firsthand knowledge of the performance.
Questionnaires are to be returned via email by the Offeror’s Reference to Maria Riza R. Owen, Contract Specialist at maria.owen2@va.gov. The email subject line should include 36C25526R0023, Past Performance Questionnaire.
Questionnaires are to be returned by the Solicitation’s due date/time identified on SF 1449, block 8, unless it has been extended via Solicitation Amendment.
Questionnaires submitted by the Offeror will not be considered.
Business Name: _____________________________________________________________
Business Address: ___________________________________________________________
Contact Person: ___________________________ Title: ____________________________
Email Address: ______________________________________________________________
Telephone Number: _________________________ Contract Value: $__________________
Contract Number/Reference: ___________________________________________________
Contract Period of Performance Dates: ___________________________________________
BRIEF DESCRIPTION OF SERVICES PROVIDED:
PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the offeror’s performance or situation. If you are unable to rate an item because it was not a requirement, never an issue, or you have no knowledge of the item in question, then you should mark “NA”.
Exceptional. (6) Performance meets contractual requirements and exceeds many requirements to the government’s benefit. (Risk Level: Very Low)
Very Good. (5) Performance meets contractual requirements and exceeds some to the government’s benefit. (Risk Level: Low)
Satisfactory. (4) Performance meets contractual requirements. (Risk Level: Moderate)
Marginal. (3) Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet implemented satisfactory corrective actions. (Risk Level: High)
Unsatisfactory. (2) Performance does not meet contractual requirements and recovery is not likely in a timely manner. Contractor’s corrective actions to date are ineffective (Risk Level: Very High)
Unknown. (1) The offeror has little/no relevant past performance upon which to base a meaningful performance risk prediction. (Risk Level: Unknown)
a. QUALITY OF PRODUCT OR SERVICE:
(1) The Contractor provided services that conformed to contract requirements, specifications, and standards of safety.
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| NA |
| (2) The Contractor submitted accurate reports/surveys. |
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| NA |
(3) The Contractor utilized personnel that were appropriate to the effort performed.
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| NA |
(4) The Contractor established and maintained adequate management of subcontractors to ensure quality service.
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| NA |
b. PRICE CONTROL:
| (1) The Contractor performed the effort within the cost/price. |
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| NA |
| (2) The Contractor submitted accurate invoices on a timely basis. |
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| NA |
c. TIMELINESS/SCHEDULE:
(1) The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract.
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| NA |
| (2) The Contractor was responsive to technical and/or contractual direction. |
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| NA |
d. BUSINESS RELATIONSHIPS:
| (1) The Contractor demonstrated effective management over the effort performed. |
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| NA |
(2) The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) was apprised of technical, cost, and safety issues.
NA
(3) The Contractor presented information, reports, surveys and correspondence in a clear, concise, and businesslike manner.
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(4) The Contractor promptly notified the COR and/or Contracting Officer in a timely manner regarding urgent issues.
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(5) The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical contract issues.
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| NA |
e. KEY PERSONNEL:
(1) The Contractor provided qualified personnel to fulfill the requirements of the contract.
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| NA |
A. OTHER:
(1) Would you award this contractor/offeror another contract? ( ) Yes, ( ) No If you answered “No” provide an explanation.
(2) Was the contract terminated for default? ( ) Yes, ( ) No If you answered “Yes”, provide an explanation.
(3) Has the contractor/offeror ever been given a cure notice, show cause notice, suspension of progress payments, etc.? ( ) Yes, ( ) No If you answered “Yes”, provide an explanation.
(4) Based upon the information you provided and using the definitions provided in the evaluation criteria above, the overall performance rating you would give this contractor is:
Exceptional , Very Good , Satisfactory , Marginal , Unsatisfactory , Unknown , COMMENTS: (ALL Unsatisfactory, Marginal, Very Good, or Exceptional Ratings require comments to support the same.)
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