Past_Performance_Questionnaire.docx
DOCX document 39 KB Posted
- Solicitation number
- 36C24926R0057
About this file
This is a Past Performance Questionnaire designed to evaluate contractors' previous experience and qualifications for the Building 204 Cath Lab II renovation project at the James H. Quillen VA Medical Center in Mountain Home, Tennessee. The questionnaire serves as a template for soliciting information from prospective bidders regarding their relevant past performance on similar construction and renovation projects, enabling the contracting officer to assess contractor capability, reliability, and track record before award.
The questionnaire typically requests detailed information about the contractor's experience on comparable projects, including project scope, contract values, completion dates, client references, and performance metrics such as schedule adherence, quality of work, and safety records. Contractors responding to solicitation 36C24926R0057 are expected to demonstrate experience with medical facility renovations, laboratory construction or renovation work, coordination with healthcare facility operations, and project management capabilities similar to those required for the Cath Lab II renovation. The responses allow the Department of Veterans Affairs Veterans Health Administration to evaluate technical competency and past performance as evaluation criteria in the source selection process for this renovation contract.
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Text version
Past Performance Questionnaire (PPQ) Section A – Project Information (Offeror Completes) Project Title: _________________________________________________ Customer/Owner (Agency/Organization): _________________________________________________ Contract/Task Order Number: _________________________________________________ Place of Performance: _________________________________________________ Period of Performance: _________________________________________________ Total Final Contract Value: _________________________________________________ Type of Contract: _________________________________________________ Project Description: _________________________________________________ Relevance to Hospital Procedure Room Projects: _________________________________________________ Key Subcontractors: _________________________________________________ Safety Metrics: _________________________________________________ Section B – Reference Contact (Reference Completes) Reference Name & Title: _________________________________________________ Agency/Organization: _________________________________________________ Role on Project: _________________________________________________ Phone: _________________________________________________ Email: _________________________________________________ Would you contract with this firm again? _________________________________________________ Section C – Performance Ratings (1–5 or N/A) Quality of Work Rating: _________________________________________________ Comments: _________________________________________________ Timeliness & Schedule Performance Rating: _________________________________________________ Comments: _________________________________________________ Cost Control Rating: _________________________________________________ Comments: _________________________________________________ Management Effectiveness Rating: _________________________________________________ Comments: _________________________________________________ Customer Satisfaction Rating: _________________________________________________ Comments: _________________________________________________ Safety Performance Rating: _________________________________________________ Comments: _________________________________________________ Relevance to Hospital Procedure Room Projects Rating: _________________________________________________ Comments: _________________________________________________ Section D – Additional Information Nonconformances?: _________________________________________________ Schedule Impacts: _________________________________________________ Cost Growth: _________________________________________________ Safety Incidents: _________________________________________________ Clinical Coordination performance: _________________________________________________ Overall Performance Trend: _________________________________________________ Section E – Overall Confidence Rating Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence Unknown (Neutral) Rationale: _________________________________________________ Signature: __________________________ Date: __________
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