Past Performance Questionnaire (2 Pages).docx
DOCX document 19 KB Posted
- Solicitation number
- 36C24823R0138
About this file
This document contains a pre-solicitation notice for architectural and engineering services. The Department of Veterans Affairs is seeking an AE firm to provide design services for a project to renovate the kitchen space and replace equipment at the West Palm Beach VA Medical Center located in West Palm Beach, Florida. The project involves renovating approximately 12,000 square feet of the main kitchen, including walls, ceilings, floors, mechanical, electrical and plumbing systems, and replacing fixed equipment. Interested firms should submit Standard Form 330 along with required certifications and other information by May 29, 2023. Submissions will be evaluated based on professional qualifications, specialized experience, capacity, past performance, and location. The anticipated award date for the design contract is September 30, 2023. The estimated construction cost is between $5-10 million. The pre-solicitation is set aside for Service-Disabled Veteran-Owned Small Businesses.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24823R0138_3.docx | DOCX document | |
| Statement of Work - AE Renovate Kitchen Space and Replace Equipment (100 Pages).pdf | ||
| 36C24823R0138_1.docx | DOCX document |
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Text version
CONTRACTOR PERFORMANCE QUESTIONNAIRE 36C24823R0138
Note: Each contractor will send this questionnaire to the individual Firm who will provide Past Performance information for relevant projects. The individual completing the questionnaire will send the form directly to the Contracting Officer issuing the Pre-Solicitation Notice/SOW. Firms may also send a completed CPARs for relevant projects.
a) The A&E will fill out Section A
b) The Evaluator fills out Section B including the performance elements.
c) The evaluating Firm will email the forms directly to the Contracting Officer.
Please return the completed questionnaire to the following Email address: anthony.caruvana@va.gov
CONTRACTOR PERFORMANCE QUESTIONNAIRE
| SECTION A - CONTRACT INFORMATION |
| (TO BE COMPLETED BY A/E FIRM) |
| A/E Firm’s Name: Address: |
| Point of Contact Name: |
POC Phone Number: POC Email:
Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain) Percent of project work performed:
If subcontractor, who was the prime (Name/Phone #):
| Contract Location: Contract Title: |
| Contract Number: |
Delivery/Task Order Number (if applicable): Period of Performance: Dollar Amount of Contract: $
SERVICES PERFORMED:
SECTION B - CLIENT
INFORMATION
(TO BE COMPLETED BY
CLIENT)
Company Name:
Phone Number (Including area code):
POC Name and Title: Email Address:
RATE EACH PERFOMANCE ELEMENT LISTED BELOW (1 THROUGH 4), BY CHECKING THE APPROPRIATE NUMBER THAT BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR'S PERFORMANCE.
COMPLETED FORM TO BE EMAILED TO: anthony.caruvana@va.gov
5 = EXCEPTIONAL, 4= VERY GOOD, 3 = SATISFACTORY, 2 = MARGINAL, 1 =UNSATISFACTORY
| 1. Contractor provides, or provided, the required Professional A&E Services in accordance with the requirements (quality, quantity, timeliness) of the contract? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| 2. Does the Contractor provide design documents and specifications that are accurate? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| 3. Does the Contractor provide accurate invoices and timely? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| 4. Based on the contractor’s performance of this contract, provide a rating of the contractor’s overall performance. |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
In addition to the rating, provide any additional comments/observations not specifically addressed in the performance elements:
Date Questionnaire was completed (mm/dd/yyyy):
| Client's Signature: |
| Client’s Print Name: |
File details come from the government source that posted it. Updated .