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This document contains a past performance survey template and details of a federal contract opportunity for special mode transportation services. The past performance survey is to be completed by references for the offeror bidding on contract number 36C24821Q0592 with the Department of Veterans Affairs for special transportation services for the North Florida/South Georgia Veterans Health System South Region. It requests information on previous contracts performed for the reference such as dollar amount, dates of performance and contract number. It also asks the reference to comment on quality of work and flexibility handling changes. The federal contract opportunity is a combined synopsis/solicitation for these special transportation services with a response date of May 7, 2021. It is a SDVOSB set-aside under NAICS code 485991 for the VA's VISN 8 network.

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36C24821Q0592 NF/SG VHS Special Mode Transportation Services - South Region

Past Performance Survey Offeror Name: ________________

OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be included with the offeror’s technical proposal.

EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the Offeror listed above for award of a VA contract. Your comments would be appreciated regarding this firm’s past performance. Your comments are considered Source Selection Sensitive. Under Federal Acquisition Regulation Part 15.506, the name of the individuals providing reference information is confidential and will not be released or made publicly available.

Name of Company being evaluated:

Evaluator’s Name:

Evaluator’s Company Name, Address and Phone number:

What contracts did this offeror perform for your company? Provide the total contract amount, dates of performance, and contract number.

Evaluation Questions Comment on the overall quality of contractor’s work.

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

If any changes were needed, was the contractor flexible in responding to those changes?

Signature Date:

Offeror Name:
Name of Company being evaluated:
Evaluators Name:
Evaluators Company Name Address and Phone number:
What contracts did this offeror perform for your company Provide the total contract amount dates of performance and contract number:
Comment on the overall quality of contractors work:
Were there any performance issuesconcerns If so how were they handled:
If any changes were needed was the contractor flexible in responding to those changes:
Signature:
Date:

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