Exhibit N Past Performance Questionnaire.pdf

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 any further in filling out the form and email (preferred), or mail the questionnaire back to the Contract Specialists. 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.

Attn: Wallace Taylor, Lease Contracting Officer

Department of Veterans Affairs, NCO 17

Subject: Past Performance Questionnaire Lease #

Email: wallace.taylorjr.@va.gov

For assistance with this questionnaire please contact the Contract Officer listed above. Hand written responses will be accepted. Responses will be treated as confidential and procurement sensitive.

Past Performance Evaluation:

PASS evaluation if, ALL questions on the following page are answered as ACCEPTABLE.

PASS evaluation if, the Offeror has no relevant past performance.

FAIL evaluation if, ANY question on the following page is answered as NOT ACCEPTABLE.

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

Explanation of Codes:

ACCEPTABLE – Offeror meets the minimum technical requirement

NOT ACCEPTABLE – Offeror has failed to meet the minimum requirement

EXHIBIT K - PAST PERFORMANCE QUESTIONNAIRE

mailto:Javar.Whittington@va.gov VHANTXWhiteD4 Inserted Text W

VA RLP #

VA Lease #

SECTION 1 – Offeror (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:

Name: Title:

Phone Number: Email:

Lease Square Footage: Organization/ Company:

Use of Space (Check One): Office Medical Office Other

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 If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain:

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

Acceptable Not Acceptable If Not Acceptable, please explain: