Past Performance Survey.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C26125R0006
About this file
This document is a Past Performance Survey related to a federal contract opportunity for HUD-VASH Housing Placement and Case Management Services for the Department of Veterans Affairs, Network Contracting Office 21.
The survey is being used to evaluate the past performance of an offeror being considered for award of the contract. It asks the evaluator to rate the offeror's performance on various criteria such as compliance with contract requirements, timeliness, personnel management, quality of work, responsiveness, and customer satisfaction. The evaluator is also asked to indicate whether they would award another contract to the offeror and if the customer was satisfied with the services provided. The completed survey is to be returned directly to Emily.Trinh@va.gov by December 11, 2024.
The related federal contract opportunity is a solicitation (36C26125R0006) for HUD-VASH Housing Placement and Case Management Services for the San Francisco VA Health Care System. The solicitation is set aside for small businesses under NAICS code 624229 with a $19 million size standard. The government intends to award a single Indefinite Delivery Indefinite Quantity contract as a result of this solicitation.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26125R0006 0002.docx | DOCX document | |
| 36C26125R0006 0001.docx | DOCX document | |
| 36C26125R0006.docx | DOCX document | |
| SOP 803 Safety for Staff Working in the Community Staff.pdf | ||
| Quality Assurance Surveillance Plan.pdf | ||
| Wage Determination 2015-5637.pdf |
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Text version
Past Performance Survey
Company Name: __________________________________
Reference 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; therefore, you are advised that the Federal Acquisition Regulation (FAR) 15.506 prohibits the release of the names of the individuals providing reference information about the Offeror’s past performance. Survey should be completed by the evaluator and returned to Emily.Trinh@va,gov, no later than December 11, 2024 12:00PM PST.
Please evaluate the Past Performance using only the following ratings without variation. If the rating is Marginal or Unacceptable, provide additional information in the appropriate block or in the remarks section of this form.
Outstanding = Performance greatly exceeded contract requirements
Above Average = Performance exceeded contract requirements
Satisfactory = Performance met contract requirements
Marginal = Performance met the minimum contract requirements but some material aspects of the contractor’s performance were less than satisfactory.
Unacceptable = Performance was poor and/or did not satisfy contract requirements
Describe exactly what types housing placement and case management services or similar service(s) were provided to your company/organization?
Length of the Service (Provide dates):
| Rate the following questions if the company provided temporary medical staffing or similar services. Provide information/comments in the Remarks Section below. |
| Circle One |
| To what extent did the contractor comply with contract requirements? |
| Choose an item. |
| How timely was the contractor’s performance? |
| Choose an item. |
| How well did the contractor comply with the labor and safety standards? |
| Choose an item. |
| Rate the effectiveness of the contractor’s management of the contract? |
| Choose an item. |
| Rate the contractor’s handling of staff integrity issues. |
| Choose an item. |
| Rate the contractor’s personnel management practices. |
| Choose an item. |
| Quality Control: Rate the overall quality of contractor’s work. |
| Choose an item. |
| What extent was contractor flexible in responding to changing needs? |
| Choose an item. |
| To what extent was the contractor reliable? |
| Choose an item. |
| To what extent was the Contractor responsive to technical directions? |
| Choose an item. |
| Have any cure notices, show cause letters, suspension of payment, or termination been issued? If yes, explain on the following page. |
| Choose an item. |
| Would you award another contract to this contractor? If no, explain on the following page. |
| Choose an item. |
| Was the customer satisfied with the service provided? If no, explain on the following page. |
| Choose an item. |
| To what extent did contractor notify you of problems of potential issues? |
| Choose an item. |
| Did the Contractor submit accurate invoices during the performance period? |
| Choose an item. |
| Was the contractor professional and courteous in its interaction with you? |
| Choose an item. |
| Did the contractor respond promptly to requests? |
| Choose an item. |
| Did the contractor meet all expectations under the contract? |
| Choose an item. |
Evaluator’s Additional Remarks regarding services:
Signature of Evaluator: Date of Evaluation:
Print Name of Evaluator:
Please email signed copy directly to Emily.Trinh@va.gov DO NOT return survey to the company you are evaluating.
File details come from the government source that posted it. Updated .