Past Performance Questionnaire.docx

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Attached to
U006--CH36 - Personalized Career Planning & Guidance Federal contract opportunity
Solicitation number
36C10E20R0004
Issued by
Department of Veterans Affairs Veteran Benefits Administration Headquarters

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Text version

PERSONALIZED CAREER PLANNING AND GUIDANCE (PCPG)

PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE QUESTIONAIRE

Contractor’s Name:

Contract Number & Total Contract Value_____________________________________________ Contract Title___________________________________________________________________ Contract Total Period of Performance_________________________________________________ Was Contractor Prime or Sub for this contract?___________________________________ Name of Person Completing the Evaluation:

Title:Agency/Company:
Telephone:E-mail:

Please rate the contractor in each of the following areas. Note: there is room for comments that will be helpful to our evaluation.

· Not Applicable: N/A

· 1: Performance clearly below the contract performance standard or requirement

· 2: Performance occasionally does not meet minimum contract performance standard or requirement

· 3: Performance that meets the minimum contract performance standard or requirement

· 4: Performance that meets and occasionally exceeds the contract performance standard or requirement

· 5: Performance that almost always exceeds the contract performance standard or requirement

1. Overall Quality of Goods/Services Provided
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

What was the quality of the Contractors performance in executing the scope of the contract? Were key personnel qualified, professional, & reliable? Was the Contractor flexible in responding to emerging issues and implementing required solutions? Please provide comments below:

2. Satisfaction of Contractor Delivery Schedule/Timeliness

N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Was the Contractors delivery performance on time with the contract schedule? Were they consistent in meeting the schedule & milestones? Was the Contractor responsive to technical direction? Was the Contractor timely to Government/customer inquiries? Please provide comments below:

3. Satisfaction of Contractors Cost Control
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Was the Contractor timely in submitting invoices? Did the Contractor submit accurate invoices in accordance with the price schedule of the contract? Please provide comments below:

4. Satisfaction of Management/Business Relations
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Was Contractor businesslike in all correspondence? Was Contractor responsive to contract requirements?

Did Contractor have proactive approach? Did the Contractor solve/handle problems in a quick & professional manner? Was Contractor prompt in notifying the Agency/customer of any problems.

Please provide comments below:

5. Regulatory
N/A |_|
1 |_|
2 |_|
3 |_|
4 |_|
5 |_|

Were there any regulatory issues with the Contractors performance? Please provide comments below:

6. Please provide a description of the services/products provided by the Contractor for this contract.

7. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem to this contractor in the past 3 years?

|_| Yes |_| No If Yes, please explain.

8. Have you terminated this contractor for cause/default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.

9. Have you filed past performance information in the CPARS database that the contracting officer may search?|_| Yes |_| No Please explain.

10. Based on the contractor’s overall performance, would you award them another contract?

|_| Yes |_| No If No, please explain.

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