PAST AND PRESENT PERFORMANCE QUESTIONNAIRE.docx

DOCX document 36 KB Posted

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Z2DA--FY26: NRM (PROJ: 673-21-116) BB - Restoration of Building 1 Envelope
Solicitation number
36C24826R0011
Issued by

About this file

This document is a Past and Present Performance Questionnaire for a Department of Veterans Affairs contract opportunity (Solicitation Number 36C24826R0011) for the restoration of Building 1 envelope at James A. Haley VA Hospital in Tampa, Florida. The project is valued between $5 million and $10 million, with proposals due on 12/03/2025 at 2:00 PM EST, and involves comprehensive renovation including general construction, alterations, abatement, removal of existing structures, and new building components.

The performance questionnaire is designed to capture detailed performance ratings across 22 specific evaluation criteria, including contractor management, personnel capabilities, problem-solving, schedule adherence, quality control, and overall performance. Key administrative details include a mandatory site visit scheduled for 11/12/2025 at 10:00 AM EST, with interested parties required to confirm attendance with Healthcare Engineer Nicole Dayton. The solicitation allows for a 120-day offer acceptance period and is being managed by Contracting Officer David Hernandez from the VA Network Contracting Office 8.

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Other files

File Type Posted
36C24826R0011 0006-ko.pdf PDF
673-21-116-James Haley Restor B1_Addendum 03_02.23.26.pdf PDF
VA NOTICE OF LIMITATIONS ON SUBCONTRACTING.pdf PDF
36C24826R0011 0005.pdf PDF
36C24826R0011 0004.pdf PDF
36C24826R0011 0003.pdf PDF
WD-FL20260208 01-02-26.pdf PDF
36C24826R0011 0002.pdf PDF
SIGNING SHEET 1.pdf PDF
36C24826R0011 0001.pdf PDF
673-21-116-James Haley Restor B1_Addendum 01_11.24.2025.pdf PDF
SIGNING SHEET 2.pdf PDF
36C24826R0011_1.docx DOCX document
36C24826R0011_1.docx DOCX document
36C24826R0011_1.docx DOCX document
EMR 1 page.pdf PDF
Experience information Sheet.pdf PDF
7a CD3 Drawings.pdf PDF
WD FL20250208 05232025.pdf PDF
Base Offer Price Breakdown - 1 page.xlsx XLSX spreadsheet
7 100 CD3 Specs.pdf PDF
7 Tampa site map.pdf PDF
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Text version

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS TO CONTRACTOR

Complete the CONTRACTOR INFORMATION section below in light blue shaded boxes. Send to the point of contact listed requesting they please complete the form and submit it according to the instructions below.

INSTRUCTIONS TO REFERENCE CONTACT

The contractor named below is submitting an offer for a United States Department of Veterans Affairs contract requirement, and has sent this form to you, in your role as a past performance reference contact. Please complete this form in full (all areas shaded in light yellow, below). Once completed, please send the form to the Contracting Officer only by email:

Department of Veterans Affairs NCO 8 Contracting Office TO: David Hernandez Contracting Officer, Email: david.hernandez1@va.gov

REF SOLICITATION NUMBER: 36C24826R0011

Please return before required due date of 12/03/ 2025 at 2:00 PM EST.

If you are unable to provide this information, please inform the Contractor listed below.

CONTRACTOR INFORMATION [completed by Contractor] Contractor Company Name

Street Address

Contractor Point of Contact Name

City

Point of Contact Phone Number

State

Reference Project Title

Zip Code

Contract POP (start to finish):

Email

Contract Number

Contract Dollar Value

Description of Work

Role of Contractor on This Project (check appropriate box)

· Prime Contractor ☐ Sub-contractor ☐ Key Personnel

RESPONDENT INFORMATION [completed by Reference Contact] Company Name

Street Address

POC Name

City

Phone Number

State

Fax Number

Zip Code

Email

PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2 in the applicable text box OR in the Remarks section, below (text box will expand to whatever extent is necessary).

1
2
3
4
5
6
UNSATISFACTORY
MARGINAL
SATISFACT ORY
VERY GOOD
EXCEPTIONAL
NEUTRAL
Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.
Performance did not meet some contractual requirements.

There were problems, some of a serious nature, for which corrective action was only marginally effective.

Performance met contractual requirements. There were some minor problems and corrective actions taken by the contractor are satisfactory.
Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.
Performance met all contract requirements and exceeded many to the government’s benefit.

Problems, if any, were negligible and were resolved in a timely, highly effective manner.

No record of past performance or the record is inconclusive

The Contractor …
1
2
3
4
5
6
1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

Narrative:

☐
☐
☐
☐
☐
☐
2.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

Narrative:

☐
☐
☐
☐
☐
☐
3.
Delegated authority to project managers and supervisors commensurate with contract requirements.

Narrative:

☐
☐
☐
☐
☐
☐
4.
Home office participated in solving significant local problems. Narrative:
☐
☐
☐
☐
☐
☐
5.
Followed approved quality control plan. Narrative:
☐
☐
☐
☐
☐
☐
6.
Provided effective quality control and/or inspection procedures to meet contract requirements.

Narrative:

☐
☐
☐
☐
☐
☐
7.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.

Narrative:

☐
☐
☐
☐
☐
☐
8.
Provided timely resolution of contract discrepancies Narrative:
☐
☐
☐
☐
☐
☐
9.
Identified problems as they occurred. Narrative:
☐
☐
☐
☐
☐
☐
10.
Suggested alternative approaches to problems.

Narrative:

☐
☐
☐
☐
☐
☐
11.
Displayed initiative to solve problems. Narrative
☐
☐
☐
☐
☐
☐
12.
Developed realistic progress schedules. Narrative:
☐
☐
☐
☐
☐
☐
13.
Met established project schedules. Narrative:
☐
☐
☐
☐
☐
☐
14.
Provided timely resolution of warranty defects. Narrative:
☐
☐
☐
☐
☐
☐
15.
Was responsive to contract changes. Narrative:
☐
☐
☐
☐
☐
☐
16.
Provided adequate project supervision. Narrative:
☐
☐
☐
☐
☐
☐
17.
Obtained consent of surety for increases in bonding as work-in-progress increased.

Narrative:

☐
☐
☐
☐
☐
☐
18.
Paid subcontractors/suppliers in a timely manner. Narrative:
☐
☐
☐
☐
☐
☐
19.
Provided accurate and complete line item cost proposals including all aspects of work required for each task.

Narrative:

☐
☐
☐
☐
☐
☐
20.
Cooperated with Government personnel after award. Narrative:
☐
☐
☐
☐
☐
☐
21.
How would you rate the contractor's overall performance? Narrative:
☐
☐
☐
☐
☐
☐
22.
Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”
☐
YES
☐
NO
23
Would you award another contract to this contractor? If not, please explain in “remarks.”
☐
YES
☐
NO
24
To the best of your knowledge, is the contractor rated in CPARS?
☐
YES
☐
NO

REMARKS (Please use as much space as is needed – the box will expand as you type).

Printed Name/ Title Signature

Source Selection Information--See FAR 2.101 and 3.104

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