PP_Questionnaire (1).pdf
PDF 183 KB Posted
- Attached to
- C1DA--630-24-2-7653-0035 Project Title: Replace Chillers #1, #2, #4 and #5 Project Number: 630A4-22-900
- Solicitation number
- 36C24224R0079
About this file
This document is a Contractor's Past Performance Questionnaire related to a federal contract opportunity.
The key details are:
The federal contract opportunity is a Sources Sought Notice for Architect-Engineering (A/E) services to design a chiller plant replacement project at the New York Harbor Healthcare System-Brooklyn Campus. The project involves replacing four existing chillers with new chillers, modifying piping and controls, and converting the pumping plant. The anticipated award date for the A/E contract is on or before September 30, 2024. This is a 100% Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside. The magnitude of construction is between $2 million and $5 million. The A/E firm must demonstrate relevant experience in healthcare facility design, chiller plant design, and working with the Department of Veterans Affairs. The evaluation will also consider the qualifications of key personnel, capacity to perform the work, and past performance.
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Text version
Contractor's Past Performance Questionnaire
1. NAME OF FIRM/AGENCY PROVIDING FEEDBACK:
PROJECT NAME:
PERIOD OF PERFORMANCE: CONTRACT TYPE (if applicable):
CONTRACT AWARD DATE: CONTRACT COMPLETION DATE:
AWARDED VALUE: CURRENT CONTRACT DOLLAR VALUE:
2. NAME OF ASSESSING OFFICIAL:
EMAIL: PHONE NUMBER:
ASSOCIATION WITH FIRM BEING RATED (including role):
CONTRACT OR ORDER NUMBER (if applicable):
3. ASSESS THE FOLLOWING AREAS: (Check the appropriate box for each assessment category)
4 ADDITIONAL COMMENTS:
Assessment Categories Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A
a. QUALITY OF PRODUCT OR SERVICE
b. SCHEDULE
c. COST CONTROL
d. BUSINESS RELATIONS
e. MANAGEMENT OF KEY PERSONNEL
f. RELIABILITY
g. CUSTOMER SUPPORT
h. OVERALL PERFORMANCE
i. OTHER AREAS:
(1)
(2)
| 1 NAME OF FIRMAGENCY PROVIDING FEEDBACK: |
| PROJECT NAME: |
| PERIOD OF PERFORMANCE: |
| CONTRACT TYPE if applicable: |
| CONTRACT AWARD DATE: |
| CONTRACT COMPLETION DATE: |
| AWARDED VALUE: |
| CURRENT CONTRACT DOLLAR VALUE: |
| 2 NAME OF ASSESSING OFFICIAL: |
| EMAIL: |
| PHONE NUMBER: |
| ASSOCIATION WITH FIRM BEING RATED including role: |
| CONTRACT OR ORDER NUMBER if applicable: |
| Assessment Categories: |
| Unsatisfactorya QUALITY OF PRODUCT OR SERVICE: |
| Marginala QUALITY OF PRODUCT OR SERVICE: |
| Satisfactorya QUALITY OF PRODUCT OR SERVICE: |
| Very Gooda QUALITY OF PRODUCT OR SERVICE: |
| Exceptionala QUALITY OF PRODUCT OR SERVICE: |
| NAa QUALITY OF PRODUCT OR SERVICE: |
| Unsatisfactoryb SCHEDULE: |
| Marginalb SCHEDULE: |
| Satisfactoryb SCHEDULE: |
| Very Goodb SCHEDULE: |
| Exceptionalb SCHEDULE: |
| NAb SCHEDULE: |
| Unsatisfactoryc COST CONTROL: |
| Marginalc COST CONTROL: |
| Satisfactoryc COST CONTROL: |
| Very Goodc COST CONTROL: |
| Exceptionalc COST CONTROL: |
| NAc COST CONTROL: |
| Unsatisfactoryd BUSINESS RELATIONS: |
| Marginald BUSINESS RELATIONS: |
| Satisfactoryd BUSINESS RELATIONS: |
| Very Goodd BUSINESS RELATIONS: |
| Exceptionald BUSINESS RELATIONS: |
| NAd BUSINESS RELATIONS: |
| Unsatisfactorye MANAGEMENT OF KEY PERSONNEL: |
| Marginale MANAGEMENT OF KEY PERSONNEL: |
| Satisfactorye MANAGEMENT OF KEY PERSONNEL: |
| Very Goode MANAGEMENT OF KEY PERSONNEL: |
| Exceptionale MANAGEMENT OF KEY PERSONNEL: |
| NAe MANAGEMENT OF KEY PERSONNEL: |
| Unsatisfactoryf RELIABILITY: |
| Marginalf RELIABILITY: |
| Satisfactoryf RELIABILITY: |
| Very Goodf RELIABILITY: |
| Exceptionalf RELIABILITY: |
| NAf RELIABILITY: |
| Unsatisfactoryg CUSTOMER SUPPORT: |
| Marginalg CUSTOMER SUPPORT: |
| Satisfactoryg CUSTOMER SUPPORT: |
| Very Goodg CUSTOMER SUPPORT: |
| Exceptionalg CUSTOMER SUPPORT: |
| NAg CUSTOMER SUPPORT: |
| Unsatisfactoryh OVERALL PERFORMANCE: |
| Marginalh OVERALL PERFORMANCE: |
| Satisfactoryh OVERALL PERFORMANCE: |
| Very Goodh OVERALL PERFORMANCE: |
| Exceptionalh OVERALL PERFORMANCE: |
| NAh OVERALL PERFORMANCE: |
| Unsatisfactoryi OTHER AREAS: |
| Marginali OTHER AREAS: |
| Satisfactoryi OTHER AREAS: |
| Very Goodi OTHER AREAS: |
| Exceptionali OTHER AREAS: |
| NAi OTHER AREAS: |
| 1: |
| Unsatisfactory1: |
| Marginal1: |
| Satisfactory1: |
| Very Good1: |
| Exceptional1: |
| NA1: |
| 2: |
| Unsatisfactory2: |
| Marginal2: |
| Satisfactory2: |
| Very Good2: |
| Exceptional2: |
| NA2: |
| 4 ADDITIONAL COMMENTS: |
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