D4 - Past Performance Questionaire.docx
DOCX document 18 KB Posted
- Attached to
- VCB Transitional Housing Base + 4 option years (1358) Federal contract opportunity
- Solicitation number
- 36C25723Q0778
- Issued by
- Department of Veterans Affairs
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25723Q0778 0001.docx | DOCX document | |
| 36C25723Q0778.docx | DOCX document | |
| D1 - WD 2015-5225_Rev 20_27 Dec 2022_PDF.pdf | ||
| D3 - ADA Checklist (2).pdf | ||
| D6 - QASP - 3 June 2023 (2).pdf | ||
| 36C25723Q0778.docx | DOCX document | |
| D7 - INSPECTION CHECKLIST (1).pdf | ||
| D2 - Contractor Rules of Behavior.pdf | ||
| D5 - VCB Incident Report.docx | DOCX document |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
The below-named contractor is being considered for award of a contract for Solicitation No. 36C257-23-Q-0778 for transitional housing for Homeless Veterans (thereafter referred to as HCHV) to be furnished to the Department of Veterans Affairs Medical Center (VAMC), servicing the Texas Valley Coastal Bend VA Health Care System. Veterans may have specific mental health issues and some may also be mobility impaired.VA intends to engage a Contractor to provide rapid, often times same-day, residential placement that enhances the stability of Veterans served by the HCHV.
A primary consideration in our selection process is the contractor’s history of performance of similar efforts. PLEASE COMPLETE FORM and RETURN TO: nesha.nelson@va.gov. FORMS MUST BE RECEIVED BY THE CONTRACTING OFFICER NLT 30 JUNE 2023 (4:00 PM, Mountain Time)
A. GENERAL INFORMATION
Contractor’s Name: ___________________________________________________________ Address: _____________________________________________________________________ Telephone Number: _____________________ Point of Contact: ________________________
B. RESPONDENT INFORMATION
Name: _______________________________ Title: ________________________________ Organization & Address: ________________________________________________________ Telephone: __________________ Fax: ________________ Email: _____________________
C. CONTRACT INFORMATION
Contract Number/Title: __________________________________________________________ Period of Performance: ________________ Current Dollar Amount of Contract: ___________ Services Performed: ____________________________________________________________
D. PERFORMANCE INFORMATION
Choose the category on the below scale that most accurately describes the contractor’s performance or situation.
| E |
| M |
| F |
| Exceeds |
| Meets |
| Fails-please note the issue/problem/resolution |
Please use the above ratings to describe the contractor’s performance in the following areas:
1. MANAGEMENT EFFECTIVENESS
| a. Contractor provided experienced managers and supervisors with technical and administrative abilities to meet contract requirements |
| E M F |
| b. Contractor handled staff integrity issues appropriately |
| E M F |
| c. Contractor’s overall management effectiveness |
| E M F |
COMMENTS/REMARKS:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. QUALITY OF SERVICE AND WORKMANSHIP
| a. Contractor maintained safe, clean, and acceptable residential treatment facility. |
| E M F |
| b. Contractor provide appropriate treatment plans for individual treatment facility. |
| E M F |
| c. Contractor provided acceptable/immediate response when issues arose. |
| E M F |
| d. Contractor’s overall quality of service. |
| E M F |
COMMENTS/REMARKS:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. TIMELINESS/ADHERENCE TO SCHEDULES
| a. Contractor responded to technical support issues in a timely manner |
| E M F |
| b. Overall contractor timeliness |
| E M F |
COMMENTS/REMARKS:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. CUSTOMER SATISFACTION
| a. Contractor maintained a professional working relationship |
| E M F |
| b. Contractor was reasonable and cooperative in resolving any customer complaints |
| E M F |
| c. Contractor was flexible in responding to customer requirements |
| E M F |
| d. Overall customer satisfaction |
| E M F |
COMMENTS/REMARKS:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
E. If a government contract, did the contractor receive any Contract Discrepancy Reports, Letters of Concern, or Cure Notices? __________ if yes, please describe:
F. If given the opportunity, would you award another contract to this contractor? Please explain response below.
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