D.5 ATTACHMENT 5 – Past Performance 36C25525Q0562.pdf
PDF 143 KB Posted
- Solicitation number
- 36C25525Q0562
About this file
This is a Past Performance Survey template used by the Department of Veterans Affairs for solicitation number 36C25525Q0562. The survey is distributed to references and past customers to evaluate contractor performance on previous contracts. Respondents rate contractors on twelve evaluation criteria using a five-point scale: Outstanding (O), Above Average (A), Satisfactory (S), Marginal (M), and Unacceptable (U).
The survey addresses contract compliance, report accuracy, personnel qualifications, technical expertise, schedule performance, flexibility, reliability, responsiveness to technical direction, problem notification, disciplinary actions, contract award likelihood, and customer satisfaction with end products. Each criterion requires a rating and detailed comments. The completed survey must be returned to Jason.Condiff@va.gov and includes fields for evaluator name, signature, title, company affiliation, telephone number, and date. This template serves as an appendix to the solicitation and does not specify products, services, response dates, or award information.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment D.5 - Past Performance Survey Solicitation Number 36C25525Q0562
PAST PERFORMANCE SURVEY
Offeror’s Name: ___________________________________________________
Contract Number: __________________________________________________
Contract Type and Dollar Value: _______________________________________
Brief Description of Work: _____________________________________________________________________
“O” =Outstanding = Performance greatly exceeded the contract requirements “A” =Above Average = Performance exceeded the contract requirements “S” = Satisfactory = Performance met the contract requirements “M” = Marginal = Performance met the minimum contract requirements, but some material aspects of the contractor’s performance were less than satisfactory “U” = Unacceptable = Performance was poor and/or did not satisfy contract requirements Please rate and provide information and detailed comments for the following: Circle one
1. To what extent did the contractor comply with contract requirements? O A S M U
2. If reports were required, were they accurate in meeting contract requirements?
O A S M U
3. To what extent did the contractor use appropriate personnel for contract requirements?
O A S M U
4. To what extent did the contractor display technical expertise? O A S M U
5. To what extent was contractor able to meet the performance schedule? O A S M U
6. To what extent was contractor flexible in responding to changing needs? O A S M U
7. To what extent was the contractor reliable? O A S M U
8. To what extent was the contractor responsive to technical directions? O A S M U
Attachment D.3 - Past Performance Survey Solicitation Number 36C25525Q0562
Additional Comments:
Name of Evaluator: ____________________________
Signature of Evaluator: _________________________
Title: _______________________________________
Company: ___________________________________
Telephone No.: _______________________________
Date: ________________
Your assistance is requested by the Department of Veterans Affairs to assist with establishing the performance history for the Company (Offeror) named above. In efforts to expedite receipt of the requested information, please email the complete past performance questionnaire(s) to: Jason.Condiff@va.gov
9. To what extent did contractor notify you of problems or potential problems?
O A S M U
10. Have any cure notices, show cause letters, suspension of payment, or termination been issued? If yes, please explain.
O A S M U
11. Would you award another contract to the party being evaluated? If no, please explain:
O A S M U
12. Was the customer satisfied with the end product? If no, please explain: O A S M U mailto:Jason.Condiff@va.gov
File details come from the government source that posted it. Updated .