Past Performance Questionnaire.pdf
PDF 90 KB Posted
- Attached to
- R408--Radiation Oncology Assessment Services
- Solicitation number
- 36C24526Q0584
About this file
This is a Past Performance Questionnaire template used by the Department of Veterans Affairs to evaluate offerors for Radiation Oncology Assessment Services. The questionnaire is distributed to references provided by the offeror to solicit feedback on past performance under similar contracts between the reference's company and the offeror.
The questionnaire contains three primary assessment sections: (1) Quality of Performance, which requests an overall assessment and specific ratings for Assessment Services, Data Management, and Conference Coordination; (2) Cost Control, which evaluates the offeror's ability to forecast, manage, and control costs; and (3) General Comments. Respondents rate performance using four options—Exceptional (exceeded most contractual requirements with no issues), Satisfactory (meets all requirements with minor issues and effective corrective actions), Unsatisfactory (does not meet requirements with significant problems and ineffective corrective actions), or Not Applicable (unable to provide meaningful assessment). Respondents providing "Exceptional" or "Unsatisfactory" ratings must submit a brief narrative explaining their rationale. The questionnaire includes space for optional comments on each rating and requires respondent information including company name, assessor name, title, email, and date. All information provided is classified as Evaluation Information, prohibited from disclosure and exempt from Freedom of Information Act release, with respondent names protected by the VA.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
The Department of Veterans Affairs is evaluating a quote [Offeror’s name here], hereafter referred to as “Offeror,” for Radiation Oncology Assessment Services. Offeror has provided your name so that we may ask you questions regarding Offeror’s past performance on a similar contract between your company and Offeror.
Any information you provide in this questionnaire is considered Evaluation Information and is prohibited from disclosure and exempt from release under the Freedom of Information Act; as such, the Department of Veterans affairs will not release your name or the names of other individuals providing reference information about Offeror’s past performance.
Instructions: Provide an assessment of the Offeror’s past performance by checking the box with one of the following rating options. You are encouraged to write comments as often as you’d like. If your assessment is “Exceptional” or “Unsatisfactory,” then please provide a brief narrative that explains your rationale for the rating.
THANK YOU FOR YOUR SUPPORT AND PARTICIPATION!
Rating Options:
Exceptional—Offeror’s performance exceeded most contractual requirements and performance was accomplished with no issues or concerns.
Satisfactory—Offeror’s performance meets (or met) all contractual requirements and performance was accomplished with minor issues or concerns, for which Offeror’s corrective actions were effective.
Unsatisfactory—Offeror’s performance does not meet (or did not meet) contractual requirements and performance was accomplished with significant problems, issues or concerns, for which Offeror’s corrective actions were ineffective.
Not Applicable—Unable to provide a meaningful assessment.
Performance Assessment
1. Quality of performance
a. What is your overall assessment of the quality of the Offeror’s performance?
Exceptional Satisfactory Unsatisfactory N/A
Comments:
b. Assess Offeror’s quality of performance in these areas:
Exceptional Satisfactory Unsatisfactory N/A
Assessment Services
Data Management
Conference Coordination
2. Cost control
a. What is your overall assessment of the Offeror’s ability to forecast, manage and control costs?
Exceptional Satisfactory Unsatisfactory N/A
3. General comments:
_____________________________ Date:_____________ Company Name:
Assessor’s Name:
Title:
Assessor’s Email: __________________________
THANK YOU FOR YOUR SUPPORT AND PARTICIPATION!
File details come from the government source that posted it. Updated .