Past Performance Questionnaire.docx
DOCX document 16 KB Posted
- Attached to
- Q511--VISN 10 IN & MI Optical Dispensing Service
- Solicitation number
- 36C25025R0026
About this file
This document is a Past Performance Questionnaire for a VA contract (Solicitation No. 36C25025R0026) related to Optical Dispensing Services for Veterans Integrated Service Network 10 (VISN 10) covering Indiana and Michigan. The questionnaire is designed to assess a contractor's performance across eight key evaluation areas, including work quality, personnel qualification, cooperation, paperwork completeness, cost control, regulatory compliance, and overall work quality. Respondents are asked to rate performance on a scale of 1-5, with 5 representing superior performance and 1 representing unacceptable performance. The completed questionnaire is to be returned to Kristina L. Peart, Contracting Officer, at Kristina.Peart@va.gov, and will likely be used to evaluate the contractor's potential for future contract awards.
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| File | Type | Posted |
|---|---|---|
| 36C25025R0026 0001.docx | DOCX document | |
| 36C25025R0026.docx | DOCX document |
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Text version
Please complete this questionnaire in regard to the contractor or contract identified below:
| CONTRACTOR: | ___________________________________________ |
| ___________________________________________ | |
| ___________________________________________ |
RE: SOLICITATION NO. 36C25025R0026
NATURE OF WORK: VISN 10 IN & MI Optical Dispensing Service
RETURN TO: Kristina L. Peart, Contracting Officer, Kristina.Peart@va.gov
For the following questions, choose the number on the scale from 1 to 5, which most accurately describes the Contractor’s performance on the contract listed above. A “5” represents superior performance while a “1” represents unacceptable performance. If the question is not applicable, circle “N/A”. Please add any comments and information that may help to determine the Contractor’s probable performance.
1. Was the contractor’s work was performed in a skillful and 1 2 3 4 5 N/A Good workmanship like manner?
| 2. | Did the contractor provide qualified personnel necessary | 1 2 3 4 5 N/A |
| equipment and quality control for performance? |
3. Was the contractor reasonable and cooperative during 1 2 3 4 5 N/A and after contract performance?
4 Did the contractor submit paperwork timely and completely? 1 2 3 4 5 N/A
| 5. | Did the contractor consistently and adequately control | 1 2 3 4 5 N/A |
| Cost and did they adhere to their initial budget? |
| 6. | Did the contractor comply with laws, regulations, and | 1 2 3 4 5 N/A |
| facility rules? |
| 7. | Evaluate the Contractor’s overall quality of work under | 1 2 3 4 5 N/A |
| the contract. |
| 8. | Would you award similar contracts to the Contractor | 1 2 3 4 5 N/A |
| in the future? |
Past Performance Questionnaire
COMMENTS:
Thank you for your assistance.
NAME:
COMPANY/AGENCY:
ADDRESS:
PHONE:
SIGNATURE:
TITLE: _______
DATE:
PLEASE RETURN TO: Kristina L. Peart at Kristina.Peart@va.gov
File details come from the government source that posted it. Updated .