EXHIBIT L_Past Performance Questionnaire- Carson Valley CBOC.docx

EXHIBIT L

DEPARTMENT OF VETERAN AFFAIRS

PAST PERFORMANCE QUESTIONNAIRE

Introduction:

This questionnaire is designed to collect past performance information on Offerors (Landlord/ Lessors) competing for award of this lease. Please note this questionnaire is not based on the past performance of brokers facilitating the deal, but rather for the prospective awardees that will be responsible for the lease under consideration.

Instructions to the Offeror:

Please complete Section 1 on the following page. If Offeror checks the “no relevant past performance” box, then do not proceed further in filling out the form, but do submit the form as part of the offering package. If the “no relevant past performance” box IS NOT checked, then Offeror must forward a copy to 3 references, instructing them to complete sections 2 and 3. References must be current or former tenants of the Offeror. Once the respondents complete the remainder of the form, it must be returned to the Offeror and submitted as part of the Offeror’s proposal contents. Failure to submit all past performance questionnaires will be deemed as a non responsive offer.

Attn: Garry Alexander, Lease Contracting Officer Department of Veterans Affairs, RPOW Subject: Past Performance Questionnaire Contract #36C24W23R0069 Email: garry.alexander@va.gov Office: 360-815-2759 For assistance with this questionnaire please contact the Contract Specialist listed above. Hand written responses will be accepted. Responses will be treated as confidential and procurement sensitive.

Past Performance Evaluation:

Acceptable = Based on the offeror's performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror's performance record is unknown Unacceptable = Based on the offeror's performance record, the Government does not have a reasonable expectation that the offeror will be able to successfully perform the required effort.

Note: If the Offeror is a small business and receives a FAIL rating, the Contracting Officer shall seek a Certificate of Competency from the Small Business Administration. FAR 19.601

VA Contract # 36C24W23R0069 SECTION 1 – Offeror (Lessor to be evaluated) Information:

Name or Company:

Phone Number:

Email:

Only check this box if the Offeror has no relevant past performance |_| NOTE: If above statement is checked, do not proceed any further SECTION 2 - Evaluator Information:

SECTION 3 - Past Performance Questions:

1. During the tenant improvement build out, how was the Lessor’s ability to handle the pricing of change orders?

Acceptable |_| Not Acceptable |_| Please explain:

2. During the tenant improvement build out, how was the Lessor’s ability to stay on schedule?

Acceptable |_| Not Acceptable |_| Please explain:

3. During the tenant improvement build out, how was the Lessor’s ability to stay within budget?

Acceptable |_| Not Acceptable |_| Please explain:

4. In accordance with your lease, the Lessor responds promptly to any maintenance issues.

Acceptable |_| Not Acceptable |_| Please explain:

5. In accordance with your lease, the Lessor responds promptly to any safety issues.

Acceptable |_| Not Acceptable |_| Please explain:

6. In accordance with your lease, the Lessor responds promptly to any security issues.

Acceptable |_| Not Acceptable |_| Please explain:

7. In accordance with your lease, the Lessor adequately keeps the building premises and common areas clean.

Acceptable |_| Not Acceptable |_| Please explain:

8. During your lease term, the Lessor’s overall performance is acceptable.

Acceptable |_| Not Acceptable |_| Please explain: