Past Performance Questionnaire.docx

ATTACHMENT 1

PAST PERFORMANCE QUESTIONNAIRE COVER SHEET

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION#

The entire questionnaire should be forwarded to your previous customers (at least 3) for completion and customers shall directly return the cover sheet and questionnaire to Keila President at e- mail address: keila.president@va.gov It is your responsibility to ensure correct and verifiable point of contact information. Information that is incorrect or unverifiable may lead to a lower past performance rating.

(Offeror Fill-In Below)

1. Offeror Name (Name of Organization/Firm being Evaluated):

2. Name of Organization/Firm Providing Reference:

3. Address of Organization/Firm Providing Reference:

4. Contract Number:

5. Project Description:

6. Contract/Task Order Amount:

7. Performance Period:

8. Evaluator’s Point of Contact Information:

Name and Title:

Phone Number:

Fax Number:

E-Mail Address:

PAST PERFORMANCE QUESTIONNAIRE SOLICITATION RFP #36C24823Q0837

ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR

EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Confidence).

Confidence).

(Confidence).

Confidence).

confidence).

positive assessment).

EVALUATOR: PLEASE CIRCLE THE ADJECTIVAL RATING WHICH BEST

REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Subcontractor or

Ability to meet quality standards specified for technical performance

Compliance with contractual terms and conditions

Quality/integrity of technical data/report preparation efforts.

Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirement.

Effectiveness of overall contract management (including ability to effectively lead, manage, and control the project.)

E

G

S

M

P

NR

Effectiveness of on-site management and control of multidiscipline construction categories, including management of subcontractors.

Contractor was reasonable and cooperative in dealing with staff (including the ability to successfully resolve disagreements/disputes;

responsiveness to administrative reports).

Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

Ability to successfully respond to emergency situations.

Contractor proposed innovative alternative methods that reduced cost, improved maintainability or other factors that benefited the client.

Contractor’s timeliness, completeness, and accuracy in submitting invoices.

Ability to hire and retain a qualified workforce to this effort.

If this was a government contract has the contract been terminated for default or Convenience? Indicate if show cause or cure notices were issued or any default action in the comment section below.

Have there been any indications that the contractor has had any financial problem?

G S M P NR

COMMENTS:

Evaluator’s Point of Contact Information:

Signature and Title:

Phone Number:

Email Address: