PAST PERFORMANCE QUESTIONNAIRE 36C10E22Q0024.docx

PAST PERFORMANCE QUESTIONNAIRE

Solicitation 36C10E22Q0024

Complete and return NLT the date and time specified in the solicitation to:

Email: rebecca.quilhot@va.gov

On behalf of (Requester Information):

Company's Name: __________________ POC/Title/Position: __________________ Email Address: __________________ Contract/Purchase Order No.: __________________ Contract Amount: __________________ Period of Performance: __________________ Business Address: __________________ __________________ Phone Number: __________________

NOTE: DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS REQUEST

The completion of this questionnaire is requested from your agency/company in order for the Department of Veterans Affairs to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract.

Completed by:

Command/Company’s Name: _________________________________ POC/Title/Position: _________________________________ Email Address: _________________________________ Address: _________________________________ _________________________________ _________________________________ Phone Number: _________________________________

1. Quality/Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.

a. How would you describe your level of customer satisfaction? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

b. Were there any instances of rework and/or deficiency reports? (If yes, explain)

c. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?

2. Quality/Timeliness.

a. Describe the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

b. Describe the timeliness of submission of requested information, reports and invoicing.

3. Quality/Contractor Responsiveness. The offeror’s demonstrated ability to:

a. Respond to customer concerns

c. Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/under-run, Government-imposed schedule changes, etc.)

4. Additional Observations/Information

a. Identify the contractor's overall strengths and weaknesses.

b. Given hindsight, are you satisfied that the contract was awarded to this contractor? Would you be pleased to have this contractor perform work for you again? Why?

c. Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

d. Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number. (If more comment space needed, please attach additional pages.)