PP_Questionnaire.pdf
PDF 265 KB Posted
- Attached to
- S222 Grease Trap Pumping Services for VA Seattle and American Lake - Dept of Veterans Affairs
- Solicitation number
- 36C26025Q0779
About this file
The document is a Past Performance Questionnaire related to the federal contract opportunity 36C26025Q0779 for Grease Trap Pumping Services for the Department of Veterans Affairs (VA) at Seattle and American Lake facilities. The questionnaire is designed to collect performance feedback from previous clients or contracting agencies, with responses to be submitted directly to Danielle Carrico at danielle.carrico@va.gov by 8/8/2025 at 5:00pm PT.
The form provides a comprehensive assessment framework with nine performance categories, including quality of product/service, schedule, cost control, business relations, management of key personnel, reliability, customer support, overall performance, and two additional custom areas. Respondents are asked to rate each category on a scale from Unsatisfactory to Exceptional, with an option for Not Applicable. The questionnaire will be used by the Veterans Healthcare Administration (VHA) in making award decisions for the grease trap pumping services contract, which appears to have a base year and four potential option years.
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Other files
| File | Type | Posted |
|---|---|---|
| S02 RFQ 36C26025Q0779 Grease Trap Pumping.pdf |
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Text version
Past Performance Questionnaire
CONTRACT TYPE (if applicable):
CONTRACT COMPLETION DATE:
1. NAME OF FIRM/AGENCY PROVIDING FEEDBACK:
CONTRACTOR NAME:
PERIOD OF PERFORMANCE:
CONTRACT AWARD 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 TASKS PERFORMED AND ANY 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)
Responses may used in an award decision by Veterans Healthcare Administration (VHA). Please submit the response directly to Danielle Carrico, danielle.carrico@va.gov, by 8/8/2025 at 5:00pm PT. Do not send to the Contractor requesting the Questionnaire. We greatly thank you for your assistance!
36C26025Q0779
| 1 NAME OF FIRMAGENCY PROVIDING FEEDBACK: |
| 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: |
| CONTRACTOR NAME: |
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