K. Past Performance Questionnaire.pdf

DEPARTMENT OF VETERAN AFFAIRS

SOURCE SELECTION PLAN

MANHATTAN VET CENTER - NEW/RELACING LEASE

NCO 2

SOURCE SELECTION SENSITIVE FAR 2.101 and 3.104 Page 15

Attachment 4 – 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 the questionnaire is not based on the past performance of brokers facilitating the procurement, but rather for the prospective awardees that will be responsible for the lease under consideration.

Instructions for the Offeror:

Please complete Section 1 on Page 2. If the “no relevant past performance” box is checked, then do not proceed in filling out the form and email (preferred) or mail form to the Contract Specialists’ contact information below.

For the Offeror to have relevant past performance, at least one of the following must be true:

• The Offeror recently leased a space for 10,000 RSF or less within the last 3 years

• The Offeror recently leased medical office or general office space within the last 3 years

• The Offeror recently leased space to any Government entity within the last 3 years

If the Offeror has relevant past performance, the Offeror must forward a copy of this questionnaire to 3 tenant references that fulfill at least one of the criteria listed above. The Offeror must instruct the References to complete pages 3-5 of this form. Once the respondents have completed the form, they must email the form to the Contract Specialist listed below.

Attn:

Mailing Address:

Subj:

Email:

Jemeek Morris, Contract Officer Department of Veteran Affairs, NCO 2

VA Hudson Valley HCS 2094 Albany Post Road Bldg. 29, Rm 338 Montrose, NY 10548

Past Performance Questionnaire RLP# 36C24220R0129 jemeek.morris@va.gov

Office: 914-737-4400 x4124 Fax: 914-788-4878

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

mailto:jemeek.morris@va.gov

MANHATTAN VET CENTER - NEW/RELACING LEASE

NCO 2

SOURCE SELECTION SENSITIVE FAR 2.101 and 3.104 Page 16

SECTION 1 – 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 THE ABOVE STATEMENT IS CHECKED, PLEASE DO NOT PROCEED ANY FURTHER

AND EMAIL THE FORM TO THE CONTRACT SPECIALIST LISTED ON PAGE 1.

MANHATTAN VET CENTER - NEW/RELACING LEASE

NCO 2

SOURCE SELECTION SENSITIVE FAR 2.101 and 3.104 Page 17

Instructions for the Respondent:

Please complete Sections 2 and 3 on the following page to the best of your knowledge using the appropriate ratings below. When completed, please email (preferred) or mail the form to the Contract Specialists’ contact information below.

Attn:

Mailing Address:

Subj:

Email:

Jemeek Morris, Contract Officer Department of Veteran Affairs, NCO 2

VA Hudson Valley HCS 2094 Albany Post Road Bldg. 29, Rm 338 Montrose, NY 10548

Past Performance Questionnaire RLP# 36C24220R0129 jemeek.morris@va.gov

Office: 914-737-4400 x4124 Fax: 914-788-4878

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

Explanation of Codes:

EXCEPTIONAL – Lessor significantly exceeded expectations

GOOD – Lessor met and to some extent exceeded expectations

SATISFACTORY – Lessor met expectations

MARGINAL – Lessor did not fully meet expectations

UNSATSIFACTORY – Lessor failed to meet expectations

NOT APPLICABLE – Unable to provide a score mailto:jemeek.morris@va.gov

MANHATTAN VET CENTER - NEW/RELACING LEASE

NCO 2

SOURCE SELECTION SENSITIVE FAR 2.101 and 3.104 Page 18

SECTION 2 - Respondent 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:

Build Out / Cost Control

1. How satisfied were you with the Lessor’s commitment to your budget?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

2. How satisfied were you with the Lessors handling and pricing of change orders?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

3. How satisfied were you with the Lessors ability to stay on schedule?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

Lease Administration Performance

4. In accordance with your lease, how satisfied were you regarding the Lessor’s responsiveness to any maintenance issues?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

5. In accordance with your lease, how satisfied were you regarding the Lessor’s responsiveness to any safety issues?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

MANHATTAN VET CENTER - NEW/RELACING LEASE

NCO 2

SOURCE SELECTION SENSITIVE FAR 2.101 and 3.104 Page 19

6. In accordance with your lease, how satisfied were you regarding the Lessor’s responsiveness to any security issues?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

7. In accordance with your lease, how satisfied were you regarding the Lessor’s cleanliness of the building premises and common areas?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

8. In accordance with your lease, how satisfied were you regarding the Lessor’s overall performance?

Excellent Good Satisfactory Marginal Unsatisfactory Not applicable

What could have improved your score:

9. Would you sign a lease with the Lessor again?

Excellent (Yes) Unsatisfactory (No)

If no, why not: