Past Performance Questionnaire.docx
DOCX document 19 KB Posted
- Solicitation number
- 36C10E20Q0272
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| File | Type | Posted |
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| 6500.6 Appendix C.pdf.docx | DOCX document | |
| 36C10E20Q0272.docx | DOCX document |
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PAST PERFORMANCE QUESTIONNAIRE
Solicitation 36C10E20Q0272
The individual providing the reference shall complete and return NLT the date and time specified in the solicitation to:
Email: rebecca.quilhot@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.)
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