Past Performance Survey.docx
DOCX document 16 KB Posted
- Solicitation number
- 36C26124Q0922
About this file
This document is a Past Performance Survey for the federal contract opportunity 36C26124Q0922 for Annual Medical Gas Distribution and Vacuum System Maintenance (VASNHS). The survey requests an evaluator to provide information about the quality of work, any performance issues, and overall rating (Excellent, Good, Fair, Marginal, Unacceptable) for the company being considered for the contract award. The evaluator is asked to summarize the services provided, total contract amount, dates of performance, and contract number. The federal contract opportunity is being issued by the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 21 for annual medical gas and vacuum system maintenance services.
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Other files
| File | Type | Posted |
|---|---|---|
| RFQ 36C26124Q0922 Medical Gas.pdf | ||
| 2015-5593 Rev.25, LAS VEGAS - CLARK - dated 05-23-2024.pdf | ||
| Equipment List and Quantity.xlsx | XLSX spreadsheet | |
| 36C26124Q0922_1.docx | DOCX document |
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Text version
Past Performance Survey 36C26124Q0922
OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be submitted directly to durell.salaz@va.gov.
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.
Please Note: When completing this Survey be sure to summarize what service(s) you provided on the contract(s) to include the performance dates, dollar amount(s) and contract number(s).
Name of Company being evaluated:
Evaluator’s Name and signature:
Evaluator’s Company Name, Address and Phone number:
Indicate what services 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?
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