D.9 ATTACHMENT 9 - PAST PERFORMANCE SURVEY.docx

DOCX document 17 KB Posted

Attached to
J063--Fire Suppression System Inspection, Testing Maintenance, and Repair Services
Solicitation number
36C26125Q0538
Issued by

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The attached document is a Past Performance Survey form for a federal contract opportunity related to fire suppression systems services. The survey appears to be designed to collect detailed information about a vendor's prior performance on similar contracts, focusing on fire suppression systems inspection, testing, maintenance, and repair. The form likely requires contractors to provide specific references, contract details, performance ratings, and comprehensive evaluations of their historical work in fire protection and suppression system services for the Department of Veterans Affairs Veterans Health Administration, specifically within Veterans Integrated Service Network 21.

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Past Performance Survey 36C26125Q0538

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:

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 .