Past Performance Questionnaire.pdf

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Attached to
Landscaping & Snow/Ice Removal & Pest Control Twin Fall CBOC
Solicitation number
36C26026Q0002
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The Past Performance Questionnaire is a standardized form used by the Veterans Healthcare Administration (VHA) to collect performance feedback about a contractor's performance on a federal contract. The document provides a structured template for assessing various performance categories including quality of product/service, schedule, cost control, business relations, management of key personnel, reliability, customer support, and overall performance, with rating options ranging from Unsatisfactory to Exceptional.

The questionnaire requires submission directly to Contract Specialist Tyrone Whalen at tyrone.whalen@va.gov by 7/15/2025 at 5:00pm PT, with responses potentially being used in an award decision for the Landscaping & Snow/Ice Removal & Pest Control Twin Fall CBOC solicitation (36C26026Q0002). The form includes fields for capturing contract details such as contractor name, period of performance, contract award and completion dates, awarded and current contract values, and additional comments about performance or tasks completed.

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Past Performance Questionnaire

CONTRACT TYPE (if applicable):

CONTRACT COMPLETION DATE:

1. NAME OF FIRM/AGENCY PROVIDING FEEDBACK:

CONTRACTOR NAME:

PERIOD OF PERFORMANCE:

CONTRACT AWARD DATE:

AWARDED VALUE: CURRENT CONTRACT DOLLAR VALUE:

2. NAME OF ASSESSING OFFICIAL:

EMAIL: PHONE NUMBER:

ASSOCIATION WITH FIRM BEING RATED (including role):

CONTRACT OR ORDER NUMBER (if applicable):

3. ASSESS THE FOLLOWING AREAS: (Check the appropriate box for each assessment category)

4 ADDITIONAL COMMENTS ON PERFORMANCE/ TASKS PERFORMED:

Assessment Categories Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A

a. QUALITY OF PRODUCT OR SERVICE

b. SCHEDULE

c. COST CONTROL

d. BUSINESS RELATIONS

e. MANAGEMENT OF KEY PERSONNEL

f. RELIABILITY

g. CUSTOMER SUPPORT

h. OVERALL PERFORMANCE

i. OTHER AREAS:

(1)

(2)

Responses may used in an award decision by Veterans Healthcare Administration (VHA). Please submit the response directly to Contract Specialist, Tyrone Whalen, tyrone.whalen@va.gov by 7/15/2025 at 5:00pm PT. Do not send to the

Contractor requesting the Questionnaire. We greatly thank you for your assistance!

1 NAME OF FIRMAGENCY PROVIDING FEEDBACK:
PERIOD OF PERFORMANCE:
CONTRACT TYPE if applicable:
CONTRACT AWARD DATE:
CONTRACT COMPLETION DATE:
AWARDED VALUE:
CURRENT CONTRACT DOLLAR VALUE:
2 NAME OF ASSESSING OFFICIAL:
EMAIL:
PHONE NUMBER:
ASSOCIATION WITH FIRM BEING RATED including role:
CONTRACT OR ORDER NUMBER if applicable:
Assessment Categories:
Unsatisfactorya QUALITY OF PRODUCT OR SERVICE:
Marginala QUALITY OF PRODUCT OR SERVICE:
Satisfactorya QUALITY OF PRODUCT OR SERVICE:
Very Gooda QUALITY OF PRODUCT OR SERVICE:
Exceptionala QUALITY OF PRODUCT OR SERVICE:
NAa QUALITY OF PRODUCT OR SERVICE:
Unsatisfactoryb SCHEDULE:
Marginalb SCHEDULE:
Satisfactoryb SCHEDULE:
Very Goodb SCHEDULE:
Exceptionalb SCHEDULE:
NAb SCHEDULE:
Unsatisfactoryc COST CONTROL:
Marginalc COST CONTROL:
Satisfactoryc COST CONTROL:
Very Goodc COST CONTROL:
Exceptionalc COST CONTROL:
NAc COST CONTROL:
Unsatisfactoryd BUSINESS RELATIONS:
Marginald BUSINESS RELATIONS:
Satisfactoryd BUSINESS RELATIONS:
Very Goodd BUSINESS RELATIONS:
Exceptionald BUSINESS RELATIONS:
NAd BUSINESS RELATIONS:
Unsatisfactorye MANAGEMENT OF KEY PERSONNEL:
Marginale MANAGEMENT OF KEY PERSONNEL:
Satisfactorye MANAGEMENT OF KEY PERSONNEL:
Very Goode MANAGEMENT OF KEY PERSONNEL:
Exceptionale MANAGEMENT OF KEY PERSONNEL:
NAe MANAGEMENT OF KEY PERSONNEL:
Unsatisfactoryf RELIABILITY:
Marginalf RELIABILITY:
Satisfactoryf RELIABILITY:
Very Goodf RELIABILITY:
Exceptionalf RELIABILITY:
NAf RELIABILITY:
Unsatisfactoryg CUSTOMER SUPPORT:
Marginalg CUSTOMER SUPPORT:
Satisfactoryg CUSTOMER SUPPORT:
Very Goodg CUSTOMER SUPPORT:
Exceptionalg CUSTOMER SUPPORT:
NAg CUSTOMER SUPPORT:
Unsatisfactoryh OVERALL PERFORMANCE:
Marginalh OVERALL PERFORMANCE:
Satisfactoryh OVERALL PERFORMANCE:
Very Goodh OVERALL PERFORMANCE:
Exceptionalh OVERALL PERFORMANCE:
NAh OVERALL PERFORMANCE:
Unsatisfactoryi OTHER AREAS:
Marginali OTHER AREAS:
Satisfactoryi OTHER AREAS:
Very Goodi OTHER AREAS:
Exceptionali OTHER AREAS:
NAi OTHER AREAS:
1:
Unsatisfactory1:
Marginal1:
Satisfactory1:
Very Good1:
Exceptional1:
NA1:
2:
Unsatisfactory2:
Marginal2:
Satisfactory2:
Very Good2:
Exceptional2:
NA2:
4 ADDITIONAL COMMENTS:
CONTRACTOR NAME:

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