D2 - SECT D ATTACH 2 PAST PERFORMANCE QUESTIONAIRE.docx

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Attached to
S205--SOLID WASTE REMOVAL (Non-Hazardous) SERVICE BASE PLUS 4 OPTION YEARS Federal contract opportunity
Solicitation number
36C24825R0123
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8

About this file

The document is a Past Performance Questionnaire for a Solid Waste Removal Service solicitation (RFP #36C24825R0123) issued by the Department of Veterans Affairs Network Contracting Office 8. The solicitation is for non-hazardous solid waste collection services at the James A. Haley VA Hospital in Tampa, FL, with a contract period from 07/01/2025 to 06/30/2030, consisting of a base year and four option years. The contract is a Firm Fixed Price, Indefinite Delivery Type Contract with an unrestricted set-aside, using NAICS code 562111 with a small business size standard of $47.0M.

The questionnaire provides a detailed evaluation framework for rating past performance across multiple dimensions, including technical performance, contract management, quality control, safety, responsiveness, and financial stability. Ratings range from Excellent (E) to Poor (P), with defined criteria for each level. The form is designed to be completed by previous clients and directly submitted to the contracting officer, Kim Tucker, to assess a contractor's performance history and capabilities for the solid waste removal service opportunity.

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Other files for this federal contract opportunity

Other files attached to S205--SOLID WASTE REMOVAL (Non-Hazardous) SERVICE BASE PLUS 4 OPTION YEARS, newest first.
File Type Posted
D1 - SECT D ATTACH 1 PWS Solid Waste 05-28-25.pdf PDF
S02 - RFP 36C24825R0123 Solid Waste 06-04-25.docx DOCX document
36C24825R0123_1.docx DOCX document

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Text version

SOLICITATION RFP #36C24825R0123

RFP – SECTION D - ATTACHMENT 2

PAST PERFORMANCE QUESTIONNAIRE

SOLID WASTE REMOVAL SERVICE

PAST PERFORMANCE QUESTIONNAIRE - COVER SHEET

The entire questionnaire should be forwarded to your previous clients for completion and clients shall directly return the cover sheet and questionnaire to Kim Tucker at e-mail address: Kim.Tucker1@va.gov It is your responsibility to ensure correct and verifiable point of contact information. Information that is incorrect or unverifiable may lead to a lower past performance rating.

(Offeror Fill-In Below)

1. Offeror Name (Name of Organization/Firm being Evaluated):

2. Name of Organization/Firm Providing Reference:

3. Address of Organization/Firm Providing Reference:

4. Contract Number:

5. Project Description:

6. Contract/Task Order Amount:

7. Performance Period:

ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

E (EXCELLENT)
Performance meets contractual requirements and exceeds expectations. The contractual performance of the element assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. (High Confidence).
G (GOOD)
Performance meets contractual requirements and exceeds some requirements. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. (Significant Confidence).
S (SATISFACTORY)
Performance meets contractual requirements. The contractual performance of the elements contains some minor problems for which corrective action taken by the contractor is satisfactory. (Confidence).
M (MARGINAL)
Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented. (Little Confidence).
P (POOR)
Performance does not meet most contractual requirements and recovery is no likely in a timely manner. The contractual performance of the element contains serious problems for which the contractor’s corrective actions appear or were ineffective. (No confidence).
NR (NO RATING)
No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative or positive assessment).

EVALUATOR: PLEASE “X” or CIRCLE THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Was this a competitive contract?
___ YES ___ NO
Role of the contractor
___ Prime Contractor or

___ Subcontractor

Ability to meet quality standards specified for technical performance
__E __G __S __M __P __NR
Compliance with contractual terms and conditions
__E __G __S __M __P __NR
Quality/integrity of technical data/report preparation efforts.
__E __G __S __M __P __NR
Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirement.
__E __G __S __M __P __NR
Effectiveness of overall contract management (including ability to effectively lead, manage, and control the project.)
__E __G __S __M __P __NR
Effectiveness of on-site management and control of multidiscipline construction categories, including management of subcontractors.
__E __G __S __M __P __NR
Contractor was reasonable and cooperative in dealing with staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports).
__E __G __S __M __P __NR
Timeliness/effectiveness of contract problem resolution without extensive customer guidance.
__E __G __S __M __P __NR
Ability to successfully respond to emergency situations.
__E __G __S __M __P __NR
Effectiveness of material management.
__E __G __S __M __P __NR

EVALUATOR: PLEASE “X” or CIRCLE THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Contractor proposed innovative alternative methods that reduced cost, improved maintainability or other factors that benefited the client.
__E __G __S __M __P __NR
Contractor Safety Record.
__E __G __S __M __P __NR
Contractor responsiveness to safety issues.
__E __G __S __M __P __NR
Contractor’s timeliness, completeness, and accuracy in submitting invoices.
__E __G __S __M __P __NR
Ability to hire and retain a qualified workforce to this effort.
__E __G __S __M __P __NR
If this was a Government contract has the contract been terminated for default or Convenience? Indicate if show cause or cure notices were issued or any default action in the comment section below.
__E __G __S __M __P __NR
Have there been any indications that the contractor has had any financial problem?
__E __G __S __M __P __NR

EVALUATOR COMMENTS:

EVALUATOR’S POINT OF CONTACT INFORMATION:

SIGNATURE: ____________________________________________________

EVALUATOR NAME: _______________________________________________

EVALUATOR TITLE: ________________________________________________

E-MAIL ADDRESS: ___________________________________________________

PHONE NUMBER: ___________________________________________________

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