Past Performance Questionnaire.pdf

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Attached to
Y1DZ--FY26: NRM (PROJ: 673-21-145) BB Construct New Bed Tower Connector
Solicitation number
36C24825R0163_1
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About this file

This document is a Past Performance Questionnaire issued by the Department of Veterans Affairs (VA), designed to evaluate a contractor's performance across multiple dimensions. The questionnaire includes eight assessment areas such as adherence to technical requirements, project schedule completion, timeliness of material submittals, change order management, project management team effectiveness, and overall project accomplishment. Evaluators use a rating scale ranging from Outstanding (O) to Unsatisfactory (U), with definitions provided for each rating level that detail the contractor's performance quality, problem-solving capabilities, and potential for future successful contract execution.

The form is to be completed by a referenced client and returned via email to Stacy Figlinski at Stacy.Figlinski@va.gov no later than 5 calendar days prior to the RFP closing date. The questionnaire requires the client to provide contract details such as contract number, project title, contract amount, and completion date, and includes space for detailed comments and remarks for each performance category. The final sections include a binary question about whether the client would hire the contractor again and an overall performance rating, with a signature and date line for the evaluator.

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1. Concerning performance, how would you rate the contractor’s adherence to technical requirements of the contract? O G S M U N

COMMENTS/REMARKS:

2. How would you rate the contractor’s performance in completing the project in accordance with planned progress schedule? (Note – Notwithstanding changes that are legitimate to extend performance.

O G S M U N

COMMENTS/REMARKS:

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY REFERENCED CLIENT: Please return this completed questionnaire via e-mail to Stacy Figlinski, the requesting Contracting Officer at the following email addresses: Stacy.Figlinski@va.gov.

No later than 5 calendar days prior to RFP closing date. Performance definitions are found on page 4 of this document.

Note: When sending back to Contracting Officer ensure the following is in the email subject line: Solicitation Number and Company Name

Contract Number:

Project Title:

Contract Amount:

Contract Completion Date:

Contractor:

Rating scale is as follows: O=Outstanding, G=Good, S=Satisfactory, M=Marginal, U=Unsatisfactory, N=Neutral The full rating definitions are listed after the questionnaire for reference.

3. How would you rate the contractor’s timeliness of Material Submittals, Payrolls, Quality Control Plan, Safety Plans etc.? O G S M U N

COMMENTS/REMARKS:

4. How would you rate the contractor submissions of change orders in terms of the number submitted and purpose? O G S M U N

COMMENTS/REMARKS:

5. How was the Project Management Teams effectiveness? (to include use and control of subcontractors)

O G S M U N

COMMENTS/REMARKS:

6. How was the contractor’s team and rate how well they accomplished the project (to include use and control of subcontractors)

O G S M U N

COMMENTS/REMARKS:

7. Would you hire this contractor again?

COMMENTS/REMARKS:

Yes No

8. How would you rate the contractor’s OVERALL PERFORMANCE?

O G S M U N

COMMENTS/REMARKS:

Signature of Rater: ____________________________________ Date: ________________

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Adjective Past performance definition

(O) Outstanding The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded many to the government’s benefit. The company performed with very few or very minor problems, for which corrective actions taken were, or are expected to be, highly effective. Performance of completed contracts was either consistently of the highest quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an extremely strong expectation of successful performance.

(G) Good The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded some to the government’s benefit. The company performed with some minor problems, for which corrective actions taken were, or are expected to be, effective. Performance of completed contracts was either consistently of high quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to a strong expectation of successful performance.

(S) Satisfactory The offeror’s performance of previously awarded relevant contracts met contractual requirements. The company performed with some problems, for which corrective actions taken by the contractor were, or are expected to be, effective. Performance of completed contracts was consistently of adequate or better quality or exhibited a trend. The offeror’s past performance record leads to an expectation of successful performance.

(M) Marginal The offeror’s performance of previously awarded relevant contracts did not meet some contractual requirements. The contractor’s performance reflected some serious problems, performance reflected some serious problems, for which the contractor either failed to identify or implemented corrective actions in a timely manner, or for which the corrective actions implemented or proposed to be implemented were, or are expected to be, only partially effective. Performance of completed contracts was consistently of mediocre quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an expectation that successful performance might be difficult to achieve or that it can occur only with increased levels of government management and over sight.

(U) Unsatisfactory

The offeror’s performance of previously awarded relevant contracts did not meet contractual requirements, and recovery, if any, did not occur within the period of performance. The contractor’s performance reflected serious problems for which the offeror either failed to identify or implement corrective actions were mostly ineffective.

Performance of completed contracts was consistently of poor quality or exhibited a trend toward becoming so. The offeror’s past performance will not be achieved or that it can occur only with greatly increased levels of government management and oversight.

(N) Neutral The offeror lacks a record of relevant or available past performance history. Based on this, there is no expectation of either successful or unsuccessful performance.

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