Past Performance Questionnaire_CFM Healthcare A-E IDIQ_20260114.docx
DOCX document 45 KB Posted
- Attached to
- Request for SF330s (Qualifications) for CFM Healthcare A-E IDIQ - 36C10F26R50011 -- C219
- Solicitation number
- QSE--36C10F26R50011
About this file
This document is a Past Performance Questionnaire (PPQ) for the Department of Veterans Affairs (VA) Office of Construction & Facilities Management (CFM) Healthcare Architect and Engineer (A-E) Indefinite-Delivery, Indefinite-Quantity (IDIQ) Multiple Award Task Order Contract (MATOC). The solicitation (36C10F26R50011) is a 100% set-aside for Service-Disabled Veteran-Owned Small Business (SDVOSB) in the NAICS code 541330 "Engineering Services" for A-E services supporting VA facilities.
The PPQ is designed to evaluate potential contractors' past performance across seven key performance areas: quality, schedule/timeliness, communication, management/personnel, cost/financial management, subcontract management, and overall performance. Potential contractors must complete Section 1 with their contract information, and clients are asked to complete Section 2 by rating the contractor's performance using an adjectival rating system ranging from Outstanding to Unsatisfactory. The document is part of the solicitation process for selecting A-E service providers, with services potentially including planning studies, design development, site investigations, facility assessments, electrical studies, specification preparation, and construction period services.
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PRE-DECISIONAL
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
SECTION 1
CONTRACT INFORMATION – Contractor to complete #1-3
1. CONTRACTOR INFORMATION
NAME OF OFFEROR BEING EVALUATED: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
POINT OF CONTACT: Click or tap here to enter text.
CONTACT PHONE NUMBER: Click or tap here to enter text.
CONTACT EMAIL ADDRESS: Click or tap here to enter text.
WORK PERFOMED AS: Click or tap here to enter text.
PERCENT OF PROJECT WORK PERFORMED: Click or tap here to enter text.
IF SUBCONTRACTOR, WHO WAS THE PRIME? Click or tap here to enter text.
2. CONTRACT INFORMATION
CONTRACT TITLE: Click or tap here to enter text.
CONTRACT NUMBER AND DO/TO NUMBER: Click or tap here to enter text.
CONTRACT TYPE Choose an item.:
if other:
CONTRACT LOCATION: Click or tap here to enter text.
AWARD DATE: Click or tap to enter a date.
ORIGINAL CONTRACT ACCCEPTANCE (construction accepted) Date: Click or tap to enter a date.
ACTUAL CONTRACT ACCEPTANCE: Click or tap to enter a date.
EXPLAIN DIFFERENCES: Click or tap here to enter text.
ORIGINAL IMPLEMENTATION PRICE: Click or tap here to enter text.
ORIGINAL CONTRACT PRICE (all costs - design/installation/financing): Click or tap here to enter text.
FINAL CONTRACT PRICE (including modifications, if applicable): Click or tap here to enter text.
EXPLAIN DIFFERENCES: Click or tap here to enter text.
3. PROJECT DESCRIPTION
SCOPE INCLUDED IN PROJECT: Click or tap here to enter text.
HOW IS THIS PROJECT RELEVANT TO PROJECT OF SUBMISSION? Click or tap here to enter text.
SECTION 2
EVALUATOR INFORMATION – Client to complete
The U.S. Department of Veterans Affairs (VA) Office of Construction & Facilities Management (CFM) is considering the Offeror identified above for award of an Indefinite-Delivery, Indefinite Quantity (IDIQ) contract under the national healthcare Architect and Engineer (A-E) Multiple Award Task Order Contract (MATOC) – 36C10F26R50011.
Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate the company’s ability to perform the work as described in the solicitation. Please verify the accuracy of the information in Section 1 and complete the questionnaire as thoroughly as possible. VA CFM may contact you in order to obtain any additional information regarding a contract award.
Please return your completed questionnaire to the Offeror to be incorporated into the SF330 submission. PPQs should NOT be submitted directly to VA CFM by the client. Refer to the solicitation for SF330 submission due date.
EVALUATOR INFORMATION
NAME OF EVALUATOR: Click or tap here to enter text.
POSITION: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
PHONE: Click or tap here to enter text.
EMAIL: Click or tap here to enter text.
DESCRIBE YOUR ROLE IN THE PROJECT: Click or tap here to enter text.
*Please see Page 4 for Adjectival Ratings for the following:
1. QUALITY
| Ability to meet quality design and/or construction standards specified for technical performance |
| Choose an item. |
| Comments: |
2. SCHEDULE/ TIMELINESS OF PERFORMANCE
| Compliance with contract delivery/completion schedules including timely submission of data deliverables (If liquidated damages were assessed or the schedule was not met, please address below.) |
| Choose an item. |
| Comments: |
3. COMMUNICATION
| Contractor was reasonable and cooperative in dealing with client staff (including the ability to successfully resolve disagreements/disputes and responsiveness to client requests) |
| Choose an item. |
| Comments: |
4. MANAGEMENT/ PERSONNEL/ LABOR
| Effectiveness of management, including suppliers, materials, and/or labor force (including the ability to effectively lead, manage, and control the project) |
| Choose an item. |
| Continuity in the contractor’s personnel during execution of the contract (e.g., one person or team that stayed with the project throughout the contract) |
| Choose an item. |
| Comments: |
5. COST/ FINANCIAL MANGEMENT
| Ability to meet the terms and conditions within the contractually agreed price |
| Choose an item. |
| Comments: |
6. SUBCONTRACT MANAGEMENT
Ability to manage subcontracting effort, including any subcontracting issues, and the contractor’s ability to resolve the problems without extensive customer guidance
Choose an item.
Comments:
7. SUMMARY
| Would you hire or work with this firm again? If no, please explain below. |
| Choose an item. |
| Provide an overall rating for the work performed by this contractor. |
| Choose an item. |
ADDITIONAL COMMENTS:
| EVALUATOR SIGNATURE: |
| DATE: |
ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
*THIS PAGE WILL BE REMOVED FOR EVALUATION PURPOSES AND NOT BE COUNTED TOWARD THE SF330 PAGE COUNT – IT IS FOR PPQ COMPLETION PURPOSES ONLY*
| Rating |
| Definition |
| Outstanding |
| The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective. |
| Above Average |
| The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Offeror were effective. |
| Satisfactory |
| The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Offeror were satisfactory. |
| Unsatisfactory |
| Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the Offeror has yet to identify corrective actions or the Offeror’s proposed actions appear only marginally effective or were not fully implemented. |
| Not Applicable |
| No information or did not apply to your contract. |
PRE-DECISIONAL
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