Exhibit O - Past Performance Questionnaire.pdf

303 KB Posted

Attached to
X1AA--Annex-Pre-Proposal - Questions and Answers
Solicitation number
36C25025R0016
Issued by

About this file

Written by GovTribe AI ·

This is a Past Performance Questionnaire template used by the Department of Veterans Affairs (VA) to collect reference feedback on contractor performance for federal contract opportunities.

The questionnaire requests completion by references and submission to VA's Contract Officer, Lisa Newlin, at Lisa.Newlin@va.gov no later than 12:00 PM Local Time on 07/27/2026 with the subject line "RLP 36C25025R0016 [Name of Offeror], Completed Past Performance Questionnaire." The form pertains to RLP No. 36C25025R0016 and the Saginaw Auburn Annex project. The questionnaire collects identifying information about the firm being rated, the firm or agency providing feedback, the assessing official's contact details and association with the firm, and contract specifics including award date, completion date, awarded value, and current contract dollar value. References must assess the contractor across eight primary categories—Compliance with Lease Requirements, Quality of Services, Timely Delivery of Services, Business Relations, Management of Key Personnel, Reliability, Customer Support, and Overall Performance—using a five-point rating scale (Unsatisfactory, Marginal, Satisfactory, Very Good, Exceptional) or marking Not Applicable. The form includes space for two additional assessment areas and a section for supplementary comments. The Government reserves the right to verify all information submitted.

View the file

Other files

File Type Posted
36C25025R0016 0001_1.docx DOCX document
Saginaw Primary Care Clinic floor plan.zip ZIP file
36C25025R0016 Amendment 0001.pdf PDF
Exhibit P - Appendix - Applicable Codes and Standards.pdf PDF
Exhibit E - GSA Form 3517B General Clauses_Mar_2026.pdf PDF
Exhibit K - DOL Wage Determination WD MI20250077_Jan_2026.pdf PDF
Exhibit F - 1364 Proposal to Lease Space.pdf PDF
Exhibit B - Agencys Specific Requirements_ASR.pdf PDF
Exhibit A - 36C25025L0017 - Saginaw Annex Lease L100_May_2026.pdf PDF
36C25025R0016 - Saginaw Annex-RLP R100_May_2026.pdf PDF
Exhibit L - Offering Entity Acknowledgement Form.pdf PDF
Exhibit J - VA6500.6 Contractor Security IT Handbook.pdf PDF
Exhibit I - Tenant Improvements Cost Summary_TICS_ Table_Oct2024.zip ZIP file
Exhibit C - FSL Level II - VA Security Requirements and Price_Oct_2024.pdf PDF
Exhibit B.1 - Room Design Matrix-ASR-Section 9.zip ZIP file
36C25025R0016_1.docx DOCX document
Exhibit N - Pre-Proposal Conference Registration.pdf PDF
Exhibit M - Contractor Confidentiality Certificate.pdf PDF
Exhibit H - GSA Form 12000 Prelease FPLS Eval Off Bldg rev.5.2015.pdf PDF
Exhibit G - 1217 Lessor Annual Cost Statement.pdf PDF
Exhibit D - GSA Form 3516 Solicitation Provisions_Mar_2026.pdf PDF
Show all 21

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.

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. BUSINESS RELATIONS

e. MANAGEMENT OF KEY

PERSONNEL

f. RELIABILITY

g. CUSTOMER SUPPORT

h. OVERALL PERFORMANCE

i. OTHER AREAS:

(1)

(2)

5. ADDITIONAL COMMENTS:

PAST PERFORMANCE QUESTIONNAIRE

RLP No. ___________________________ Project Name: _______________________

COMPLETED BY:

SIGNATURE:

TITLE:

INSTRUCTIONS FOR REFERENCES COMPLETING THIS QUESTIONNAIRE:

VA requests that the reference completes this questionnaire and submits it directly back to VA’s Contract Officer, at Lisa.Newlin@va.gov no later than _______PM Local Time on ___________________, with a subject line that reads “RLP 36C25025R0016 [Name of Offeror], Completed Past Performance Questionnaire”.

The Government reserves the right to verify all information on this form.

1 NAME OF FIRM BEING RATED NAME OF PRIMARY CONTACT AT FIRM BEING RATED:
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:
Name of Firm:
Contact Name:
RLP No: 36C25025R0016
Project Name: Saginaw Auburn Annex
Completed by:
Title:
Time: 12:00
Date: 07/27/2026

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