Past Performance Survey.pdf

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Hoptel Services - Lake City
Solicitation number
36C24822Q1183
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About this file

This document contains a past performance survey template for a federal contractor providing hotel services to the Department of Veterans Affairs. The survey requests information on previous contracts performed for the reference including total contract amount, dates of performance, and contract number. It also includes questions regarding the quality of work, any performance issues and how they were addressed, and the contractor's flexibility responding to changes. The related federal contract opportunity is for Hoptel services in Lake City with a response date of July 1st, 2022. The NAICS code is 721110 for hotels and motels with a size standard of $35 million. The set-aside is for small businesses and the contracting agency is the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8.

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36C24822Q1183 Hoptel - Lake City

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:

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