Past Performance Questionnaire.docx

VA CONTRACTING NCO 7

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

*All PPQs are included in the page limit for SF 330 submissions.

SECTION 1

PAST PERFORMANCE QUESTIONAIRE AND COVER LETTER

NCO 7 Contracting Office is considering the Offeror identified above for award of 534-22-104, Correct Electrical Deficiencies Phase 4, at the Ralph H. Johnson VA Health Care System, Charleston, SC.

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. NCO 7 Contracting may contact you to obtain any additional information regarding a contract award.

Complete one set of letters and forms for each project identified in your firm’s SF 330 Section F, example projects which best illustrate proposed team’s qualifications for this contract. Additional space or blank sheets may be added to answer any question.

Transmittal Letter to Accompany Past Performance Questionnaire

[Insert Company Name] is currently responding to Department of Veterans Affairs (NCO 7) request for SF 330, Architect-Engineer Qualifications for a complete design to [Project Title]. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance.

[Insert Company Name] is providing past performance data to NCO 7 relating to our performance on contract [Insert contract name/number] and have identified [Insert name of reference] as the point of contact for this contract.

The request for SF 330 instructs that respondents provide customers with the attached questionnaire.

Please complete the questionnaire and submit it by [date required] directly to the NCO 7 Contracting Office Contracting Officer. The requested data MUST be submitted electronically via email to the Government representative identified below. ONLY electronic responses will be accepted. Please send responses to XXXX [Name of Contracting Specialist], Contract Specialist at [EMAIL of Contracting Specialist]. Please note that the maximum file size the VA’s email system will allow is 20MB. If submission will require multiple emails, please identify them as “x of n”.

The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to [Insert Company Name]. Please direct any questions about the acquisition or the attached questionnaire to the VISN 7 NCO point of contact identified above.

Thank you, [Insert Company Official Name and Title]

AE FIRM INFORMATION

AE Firm Name:

Telephone:

Address:

Email Address:

City | State | Zip:

Point of Contact:

Firm Tax ID Number:

Firm Cage Code:

Firm DUNS Number:

Contract Number:

Dollar Amount:

Period of Performance:

Project Title:

Description of Project:

Description of A-E Firms’ Responsibilities:

The AE Firm was the << Please select one >>:

Prime Contractor | Sub-Contractor | Consultant | Team Member

Percent of the work performed by the AE:

Other (Please describe):

EVALUATOR INFORMATION

Company or Agency Name:

Address:

City | State | Zip:

Evaluator’s Name:

Evaluator’s Title:

Evaluator’s Phone:

Evaluator’s email:

SECTION 2

PERFORMANCE INFORMATION

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* Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Marginal or Unsatisfactory on the Narrative Summary found below.

Corrective actions being taken by the contractor appear to be effective or Corrective actions taken were effective.

VA CONTRACTING NCO 7

SECTION 3

PERFORMANCE INFORMATION

A-E FIRM’S NAME: PROJECT NAME:

Contract Period of Performance:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix in Section 2.

Item

FACTORS TO BE RATED

Design Services

Follow-On Construction Support Services

LEED (If Applicable)

BIM (If Applicable)

Owner’s Representative on Design/Build Projects (If Applicable)

Overall

Number of A/E Design Errors & Omissions on Project:

(Please describe any major issues below)

Increased Project Cost Due to A/E Design Errors & Omissions (Yes | No):

(Please describe any major project impacts below)

NARRATIVE SUMMARY (Use this section to explain any rating of marginal or unsatisfactory from the previous page)

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