HT001120R0003 Atch B Past Performance Questionnaire (0001).docx
DOCX document 53 KB Posted
- Attached to
- Disability Evalution System Program Support Federal contract opportunity
- Solicitation number
- HT001120R0003
- Issued by
- Defense Health Agency
About this file
This document contains a past performance questionnaire and details of a federal contract solicitation. The Defense Health Agency is soliciting proposals to provide program support services for its Disability Evaluation System, Special Compensation for Assistance with Activities of Daily Living programs, and Physical Disability Board of Review. The contractor will also provide administrative and records management support to the DHA office in Arlington, Virginia. The goal is to improve existing programs through continuous enhancement of knowledge repositories, performance, and capabilities in accordance with Defense Department and congressional guidance. This acquisition is set aside for small businesses and utilizes Federal Acquisition Regulation Part 15 procedures. Offerors must submit responses by the date specified and include an organizational conflict of interest mitigation plan. Questions are due by May 20, 2020, with answers and amendments posted online.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| HT001120R0003 Atch E Questions and Answers (0001).pdf | ||
| HT001120R0003 (conformed to 0001).pdf | ||
| HT001120R0003-0001.pdf | ||
| HT001120R0003 Atch 01 PWS (0001).pdf | ||
| HT001120R0003 Atch B Past Performance Questionnaire.docx | DOCX document | |
| HT001120R0003 Atch 06 PII PHI and Federal Info Rqmts.pdf | ||
| HT001120R0003 Atch C Disclosure of Contracts.xlsx | XLSX spreadsheet | |
| HT001120R0003 Atch 02 DHA Form 49 NDA.pdf | ||
| HT001120R0003 Atch 01 PWS.pdf | ||
| HT001120R0003 Atch D Subcontractor Past Performance Consent.DOCX | DOCX document | |
| HT001120R0003 (final).pdf | ||
| HT001120R0003 Atch 03 Onboarding Checklist.pdf | ||
| HT001120R0003 Atch 04 DHA CAC Request Process.pdf | ||
| HT001120R0003 Atch A Pricing Sheet DES.xlsx | XLSX spreadsheet | |
| HT001120R0003 Atch 05 DCMD TASS Application.xlsx | XLSX spreadsheet |
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Text version
HT 001120 R 0003, Attachment B (0001)
PRESENT AND PERFORMANCE QUESTIONNAIRE
Offeror’s/Bidder’s Name (Company/Division): Reference Information TableBusiness Name of Reference & Address
Point of Contact
Phone number
E-mail address
Contract Number
Type
Contract Value
a. Original
b. Value at Completion
c. Reason for any Changes
Period of Performance
a. Date Completed/To Be Completed
b. Reason for Any Change
Description of Effort
HT 001120 R 0003, Attachment B (0001)
Evaluation KEY: Please use the following abbreviations to assign an applicable rating for questions 1 thru 6 below:
| P/U |
| S |
| G |
| VG |
| E |
| N |
| Poor Unsatisfactory |
| Satisfactory |
| Good |
| Very Good |
| Excellent |
| Neutral |
| Does not meet minimum acceptable standards in one or more areas; remedial action required in one or more areas; deficiencies in one or more areas, which adversely affect overall performance. |
| Meets or slightly exceeds minimum acceptable standards; adequate results; reportable deficiencies with identifiable, but not substantial, effects on overall performance. |
| Effective performance; fully responsive to contract requirements; reportable deficiencies, but with little identifiable effect on overall performance. |
| Very effective performance; fully responsive to contract requirements; contract requirements accomplished in a timely, efficient, and economical manner for the most part; only minor deficiencies with minimal effect on overall performance |
| Of exceptional merit; exemplary performance in a timely, efficient, and economical manner; very minor (if any) deficiencies with no adverse effect on overall performance |
| No record of relevant past performance or past performance information is not available |
Return completed surveys to robert.e.leblanc6.civ@mail.mil and john.j.kelley36.ctr@mail.mil.
1. How would you rate the contractor’s compliance with the delivery schedule / performance milestones?
Comments:
P/U |_| S |_| G |_| VG|_| E |_|
N |_|
2. How would you rate the contractor’s business practices (e.g. maintaining a positive working relationship, business ethics, timely and effectively resolution of any problems etc.)?
Comments:
P/U |_| S |_| G |_| VG|_| E |_|
N |_|
3. How would you rate the contractor’s record of conforming to contract requirements and to standards of good workmanship/quality of the product or service/timeliness of performance/report submission?
Comments:
P/U |_| S |_| G |_| VG|_| E |_|
N |_|
4. How would you rate the contractor’s overall compliance with the terms and conditions of your purchase order /contract?
Comments:
P/U |_| S |_| G |_| VG|_| E |_|
N |_|
5. How would you rate the contractor’s history of reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer?
Comments:
P/U |_| S |_| G |_| VG|_| E |_|
6. How would you rate the contractor’s overall performance? Comments:
P/U |_| S |_| G |_| VG|_| E |_|
7. Would you purchase services from this contractor again? Comments:
YES |_| NO |_|
EVALUATOR NAME/TITLE
File details come from the government source that posted it. Updated .