Exh K - Past Performance Questionnaire.pdf

143 KB Posted

Attached to
New Primary Care PACT Clinic: Grand Junction, CO
Solicitation number
36C24W25R0055
Issued by

About this file

Written by GovTribe AI ·

The document is a Past Performance Questionnaire, a standard form used to evaluate and document a contractor's performance on a specific contract. The form is designed to assess various performance categories including compliance with lease requirements, quality of services, timely delivery, reliability, and overall performance, with rating options ranging from Unsatisfactory to Exceptional. The questionnaire provides space for detailed contract information such as the firm being rated, the agency providing feedback, project name, contract dates, award values, and contact information for the assessing official, with a section for additional comments to provide context for the performance ratings.

View the file

Other files

File Type Posted
Amendment 7 - Primary Care - MW.pdf PDF
Amendment 6 - Primary Care - MW.pdf PDF
Amendment 5 - Primary Care - MW.pdf PDF
Amendment 4 - Primary Care - MW.pdf PDF
Amendment 3 - Primary Care - MW.pdf PDF
Amendment 2 - Primary Care - MW.pdf PDF
Amendment 1 - Primary Care - MW.pdf PDF
Exh A - Global Lease 36C24W25L0034 Template L100 (May 2025) - Primary Care.docx DOCX document
Exh B.1 - Agency Specific Requirements - Space Program - Rooms.pdf PDF
Exh D - GSA 3516 Solicitation Provisions (Feb. 2025).docx DOCX document
Exh F - GSA Form 1364 Proposal to Lease Space (Jan. 2023).pdf PDF
Exh G - GSA Form 1217 - Lessor_s Annual Cost Statement (Nov. 2016).pdf PDF
Exh J.2 - Attachment 1 LA-23-04 FAR Clause 52.204-27.docx DOCX document
Exh B.2 - Agency Specific Requirements - Room Layouts and Requirements.pdf PDF
Exh H - Prelease FPLS Evaluation Form 12000 (Part A and Part B) (May 2015).docx DOCX document
Exh C - VA Security Requirements (FSL Level II) (Oct 2024).docx DOCX document
Exh E - GSA 3517B General Clauses (Feb. 2025).docx DOCX document
Exh J.1 - FAR 52.204-24 Representation Digital (Nov. 2021).docx DOCX document
Global Request for Lease Proposal (RLP) R100 (May 2025) - Primary Care CO.pdf PDF
Exh B.3 - Agency Specific Requirements - Design Specs and Cleaning.pdf PDF
Exh I - DOL Wage Determination - Mesa CO.pdf PDF
Exh L - GSA Standard Form 330 - Architect-Engineer Qualifications.pdf PDF
Exh M - GSA Form 527 Contractor Qualifications.pdf PDF
Show all 23

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

PAST PERFORMANCE QUESTIONNAIRE

1. NAME OF FIRM BEING RATED: _____________________________________________________________ NAME OF PRIMARY CONTACT AT FIRM BEING RATED: ______________________________________________

2. NAME OF FIRM/AGENCY PROVIDING FEEDBACK: __________________________________________________ PROJECT NAME: ________________________________________________________________________ PERIOD OF PERFORMANCE: _________________ CONTRACT TYPE (if applicable): ________________________ CONTRACT AWARD DATE: __________________ CONTRACT COMPLETION DATE: _________________________ AWARDED VALUE: _______________________ CURRENT CONTRACT DOLLAR VALUE: ______________________

3. NAME OF ASSESSING OFFICIAL: ______________________________________________________________ EMAIL: ______________________________ PHONE NUMBER: ____________________________________ ASSOCIATION WITH FIRM BEING RATED (including role): ____________________________________________ CONTRACT OR ORDER NUMBER (if applicable): ___________________________________________________

4. ASSESS THE FOLLOWING AREAS: (Check the appropriate box for each assessment category)

Assessment Categories Unsatisfactory Marginal Satisfactory Very Good

Exceptional N/A

a. COMPLIANCE WITH LEASE

REQUIREMENTS

b. QUALITY OF SERVICES

c. TIMELY DELIVERY OF SERVICES

d. RELIABILITY

e. OVERALL PERFORMANCE

5. ADDITIONAL COMMENTS:

undefined:
1 NAME OF FIRM BEING RATED NAME OF PRIMARY CONTACT AT FIRM BEING RATED:
undefined_2:
NAME OF FIRMAGENCY PROVIDING FEEDBACK:
PROJECT NAME:
PERIOD OF PERFORMANCE:
CONTRACT TYPE if applicable:
CONTRACT AWARD DATE:
CONTRACT COMPLETION DATE:
AWARDED VALUE:
CURRENT CONTRACT DOLLAR VALUE:
NAME OF ASSESSING OFFICIAL:
EMAIL:
PHONE NUMBER:
ASSOCIATION WITH FIRM BEING RATED including role:
CONTRACT OR ORDER NUMBER if applicable:
Unsatisfactorya COMPLIANCE WITH LEASE REQUIREMENTS:
Marginala COMPLIANCE WITH LEASE REQUIREMENTS:
Satisfactorya COMPLIANCE WITH LEASE REQUIREMENTS:
Very Gooda COMPLIANCE WITH LEASE REQUIREMENTS:
Exceptionala COMPLIANCE WITH LEASE REQUIREMENTS:
NAa COMPLIANCE WITH LEASE REQUIREMENTS:
Unsatisfactoryb QUALITY OF SERVICES:
Marginalb QUALITY OF SERVICES:
Satisfactoryb QUALITY OF SERVICES:
Very Goodb QUALITY OF SERVICES:
Exceptionalb QUALITY OF SERVICES:
NAb QUALITY OF SERVICES:
Unsatisfactoryc TIMELY DELIVERY OF SERVICES:
Marginalc TIMELY DELIVERY OF SERVICES:
Satisfactoryc TIMELY DELIVERY OF SERVICES:
Very Goodc TIMELY DELIVERY OF SERVICES:
Exceptionalc TIMELY DELIVERY OF SERVICES:
NAc TIMELY DELIVERY OF SERVICES:
Unsatisfactoryd BUSINESS RELATIONS:
Marginald BUSINESS RELATIONS:
Satisfactoryd BUSINESS RELATIONS:
Very Goodd BUSINESS RELATIONS:
Exceptionald BUSINESS RELATIONS:
NAd BUSINESS RELATIONS:
Unsatisfactorye MANAGEMENT OF KEY PERSONNEL:
Marginale MANAGEMENT OF KEY PERSONNEL:
Satisfactorye MANAGEMENT OF KEY PERSONNEL:
Very Goode MANAGEMENT OF KEY PERSONNEL:
Exceptionale MANAGEMENT OF KEY PERSONNEL:
NAe MANAGEMENT OF KEY PERSONNEL:
Unsatisfactoryf RELIABILITY:
Marginalf RELIABILITY:
Satisfactoryf RELIABILITY:
Very Goodf RELIABILITY:
Exceptionalf RELIABILITY:
NAf RELIABILITY:
Unsatisfactoryg CUSTOMER SUPPORT:
Marginalg CUSTOMER SUPPORT:
Satisfactoryg CUSTOMER SUPPORT:
Very Goodg CUSTOMER SUPPORT:
Exceptionalg CUSTOMER SUPPORT:
NAg CUSTOMER SUPPORT:
Unsatisfactoryh OVERALL PERFORMANCE:
Marginalh OVERALL PERFORMANCE:
Satisfactoryh OVERALL PERFORMANCE:
Very Goodh OVERALL PERFORMANCE:
Exceptionalh OVERALL PERFORMANCE:
NAh OVERALL PERFORMANCE:
Unsatisfactoryi OTHER AREAS:
Marginali OTHER AREAS:
Satisfactoryi OTHER AREAS:
Very Goodi OTHER AREAS:
Exceptionali OTHER AREAS:
NAi OTHER AREAS:
1:
Unsatisfactory1:
Marginal1:
Satisfactory1:
Very Good1:
Exceptional1:
NA1:
2:
Unsatisfactory2:
Marginal2:
Satisfactory2:
Very Good2:
Exceptional2:
NA2:
5 ADDITIONAL COMMENTS:

File details come from the government source that posted it. Updated .