Past Performance Questionnaire.docx
DOCX document 23 KB Posted
- Solicitation number
- 36C10D26Q0134
- Issued by
-
Department of Veterans Affairs
About this file
This is a Past Performance Questionnaire template designed to evaluate contractor performance on federal contracts, specifically for use in evaluating past performance related to a Department of Veterans Affairs Longitudinal Study (solicitation 36C10D26Q0134) congressionally mandated under Public Law 110-389, Section 334.
The questionnaire captures evaluations across six primary performance categories, each rated on a five-point scale (1-5) with options for "Not Applicable": (1) Overall Quality of Goods/Services Provided, assessing execution quality, personnel qualifications, and flexibility; (2) Satisfaction of Contractor Delivery Schedule/Timeliness, measuring adherence to schedules, milestone consistency, and responsiveness; (3) Satisfaction of Contractors Cost Control, evaluating invoice timeliness and accuracy; (4) Satisfaction of Management/Business Relations, addressing business conduct, responsiveness, problem-solving, and communication; and (5) Regulatory Compliance, examining regulatory issues. The form also requires evaluators to describe services/products provided and answer administrative questions regarding cure notices, terminations for cause, CPARS database reporting, and overall contract award recommendation. Responses are provided by a named evaluator with contact information, and the questionnaire collects specific contract details including contractor name, contract number, total contract value, contract title, period of performance, and prime/subcontractor status. This template serves as the evaluation instrument for assessing contractor past performance on the Longitudinal Study contract opportunity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C10D26Q0134 0002.docx | DOCX document | |
| 36C10D26Q0134 0001.docx | DOCX document | |
| Wage Determination 15-4281.pdf | ||
| VA Handbook_6500_6_Appendix_C.pdf | ||
| 36C10D26Q0134.docx | DOCX document |
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Text version
Longitudinal Study
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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