Past Performance Questionnaire.docx

DOCX document 16 KB Posted

Attached to
S205--Waste & Recycle Removal Services
Solicitation number
36C26127Q0003
Issued by

About this file

This is a Past Performance Questionnaire template for the Department of Veterans Affairs' Waste and Recycle Removal Services contract solicitation (36C26127Q0003). The questionnaire is designed to be completed by references for offerors bidding on this opportunity, with separate surveys required for each reference submitted. Evaluators are instructed to provide confidential feedback on the named company's past performance, with responses to be sent to jill.williams@va.gov. The questionnaire requests specific contract information including contract amounts, performance dates, and contract numbers, followed by evaluation questions assessing overall quality of work on a five-point scale (Excellent, Good, Fair, Marginal, Unacceptable) and inquiring about any performance issues or concerns and their resolution.

The related solicitation is for Waste and Recycle Removal Services at VA Central California Health Care System, requiring the contractor to furnish labor, supervision, materials, equipment, and transportation for solid, organic waste, and recycling collection services. This is a 100% Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside, with offerors required to maintain SDVOSB verification from quote submission through final payment. Failure to submit SDVOSB certification and completion of VAAR Clause 852.219-75 will result in exclusion from evaluation and ineligibility for award.

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Past Performance Questionnaire

OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference.

Solicitation ID.: 36C26127Q0003 Title: Waste and Recycle Removal Services

EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the company listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. The name of the individuals providing reference information is confidential and will not be released or made publicly available. Email signed survey to jill.williams@va.gov

Name of Company being evaluated:

Evaluator’s Name and signature:

Evaluator’s Company Name, Address and Phone number:

Indicate what contracts did this company provided for you? Provide the total contract amount, dates of performance, and contract number.

Evaluation Questions

Please rate the overall quality of work using a scale of (Excellent, Good, Fair, Marginal, Unacceptable). Comments in support of the rating are welcome.

Were there any performance issues/concerns? If so, how were they handled?

File details come from the government source that posted it. Updated .