Past Performance Questionnaire.docx

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Attached to
J074--325-Cleveland Copier Maintenance Contract-FY2022 Copier Maintenance Contract Request
Solicitation number
36C10E22Q0080
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PAST PERFORMANCE QUESTIONNAIRE

Solicitation 36C10E22Q0080

The individual providing the reference shall complete and return NLT the date and time specified in the solicitation to:

Email: eric.davidson@va.gov

On behalf of (Requester/Contractor 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 :

Federal Agency/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 instances of rework and/or deficiency reports? (If yes, explain)

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. Additional Observations/Information

a. 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?

(If more comment space needed, please attach additional pages.)

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