Past Performance Questionnaire 36C10F24R0011.pdf

36C10F24R0011

PAST PERFORMANCE QUESTIONNAIRE (PPQ) FOR 36C10F24R0011

Your assistance is requested in support of a source selection for this solicitation.

Please complete this Questionnaire and return it via email to by the closing date and time listed in the solicitation:

SUBJECT: TAHOMA NATIONAL CEMETERY PHASE 3 DEVELOPMENT | 36C10F24R0011 | PPQ

TO: ATHENA JACKSON AT ATHENA.JACKSON@VA.GOV AND VICTORIA WAYNE AT

VICTORIA.WAYNE@VA.GOV

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C.

423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1a. CONTRACTOR NAME &

ADDRESS:

2. CONTRACT NO. & DUNS/SAM UNIQUE ENTITY IDENTIFIER (UEI):

3. CONTRACT AWARD DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

1b. NAME OF PRIME CONTRACTOR (If this questionnaire is for a team member)

6. TYPE OF CONTRACT:

7. PROJECT TITLE, LOCATION, AND DESCRIPTION (AND TOTAL CONSTRUCTION VALUE AT PROJECT

COMPLETION):

Please add a continuation page if additional space necessary.

mailto:athena.jackson@va.gov mailto:VICTORIA.WAYNE@VA.GOV

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION

a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER:

c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor and provide a brief description.

E = Exceptional S = Satisfactory U = Unsatisfactory

V/G = Very Good M = Marginal N/O = Not Observed

A. Quality of Products and Services – Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

E V/G S M U N/O

Note:

B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

E V/G S M U N/O

Note:

C. Schedule – Assess the timeliness of contractor against the schedule of activities.

E V/G S M U N/O

Note:

D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.

E V/G S M U N/O

Note:

E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.

E V/G S M U N/O

Note:

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

E V/G S M U N/O

Note:

G. Overall Assessment.

E V/G S M U N/O

Note:

Please provide any additional comments to support the ratings above: (for any ratings of E, V/G, S, M, or U, please provide some brief comments about strengths & weaknesses you observed in this contractor that help us understand your rating. Feel free to provide additional pages if necessary):

Signature: