PPQ - PR EHRM.docx

DOCX document 104 KB Posted

Attached to
C1DA--529-22-700 EHRM Infrastructure Upgrades Design Butler, PA VAMC
Solicitation number
36C77622R0031
Issued by

About this file

The documents provide details for a federal contract opportunity to design infrastructure upgrades for the VA Health Care System in Butler, Pennsylvania. The Veteran's Health Administration seeks proposals for architect-engineering services to upgrade facilities to support a new electronic health record system. Firms must submit Standard Form 330 statements of qualifications by February 18th, with the opportunity being a 100% set-aside for service-disabled veteran-owned small businesses. Shortlisted firms will then respond to a written questionnaire by addressing management approaches, challenges, design development strategies, and collaboration expectations. The anticipated award date is June 29th for a 225-day period of performance to complete design services. Construction period services will be optional line items for the awarded firm to support project implementation.

View the file

Other files

File Type Posted
AE Design SOW - Butler EHRM Infrastructure Upgrades 17 December 2021.pdf PDF
36C77622R0031.docx DOCX document

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

VA PROGRAM CONTRACTING ACTIVITY CENTRAL ● 6150 OAK TREE BLVD SUITE 300 ● INDEPENDENCE, OH 44131

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

*All PPQs are included in the 50-page limit for SF 330 submissions.

SECTION 1

CONTRACT INFORMATION – Contractor to complete #1-3

1. CONTRACTOR INFORMATION

NAME OF OFFEROR BEING EVALUATED: Click or tap here to enter text.

ADDRESS: Click or tap here to enter text.

POINT OF CONTACT: Click or tap here to enter text.

CONTACT PHONE NUMBER: Click or tap here to enter text.

CONTACT EMAIL ADDRESS: Click or tap here to enter text.

WORK PERFOMED AS: Click or tap here to enter text.

PERCENT OF PROJECT WORK PERFORMED: Click or tap here to enter text.

IF SUBCONTRACTOR, WHO WAS THE PRIME? Click or tap here to enter text.

2. CONTRACT INFORMATION

CONTRACT TITLE: Click or tap here to enter text.

CONTRACT NUMBER AND DO/TO NUMBER: Click or tap here to enter text.

CONTRACT TYPE: Choose an item.

if other:

CONTRACT LOCATION: Click or tap here to enter text.

AWARD DATE: Click or tap to enter a date.

ORIGINAL CONTRACT ACCCEPTANCE (construction accepted) Date: Click or tap to enter a date.

ACTUAL CONTRACT ACCEPTANCE: Click or tap to enter a date.

EXPLAIN DIFFERENCES: Click or tap here to enter text.

ORIGINAL IMPLEMENTATION PRICE: Click or tap here to enter text.

ORIGINAL CONTRACT PRICE (all costs - design/installation/financing): Click or tap here to enter text.

FINAL CONTRACT PRICE (including modifications, if applicable): Click or tap here to enter text.

EXPLAIN DIFFERENCES: Click or tap here to enter text.

3. PROJECT DESCRIPTION

SCOPE INCLUDED IN PROJECT: Click or tap here to enter text.

HOW IS THIS PROJECT RELEVANT TO PROJECT OF SUBMISSION? Click or tap here to enter text.

SECTION 2

EVALUATOR INFORMATION – Client to complete

Veterans Health Administration (VHA) Program Contracting Activity Central (PCAC) is considering the Offeror identified above for award of the Electronic Health Record Modernization Infrastructure Upgrades Design at VA Health Care System, 325 New Castle Rd., Butler, PA 16001.

Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate the company’s ability to perform the work as described in the solicitation. Please verify the accuracy of the information in Section 1 and complete the questionnaire as thoroughly as possible. VHA-PCAC may contact you in order to obtain any additional information regarding a contract award.

Please return your completed questionnaire to the Offeror to be incorporated into the SF 330 submission. PPQs should not be submitted directly to VHA PCAC by the client. Refer to the solicitation for SF 330 submission due date.

EVALUATOR INFORMATION

NAME OF EVALUATOR: Click or tap here to enter text.

POSITION: Click or tap here to enter text.

ADDRESS: Click or tap here to enter text.

PHONE: Click or tap here to enter text.

EMAIL: Click or tap here to enter text.

DESCRIBE YOUR ROLE IN THE PROJECT: Click or tap here to enter text.

*Please see Page 4 for Adjectival Ratings for the following:

1. QUALITY

Ability to meet quality design and/or construction standards specified for technical performance
Choose an item.
Comments:

2. SCHEDULE/ TIMELINESS OF PERFORMANCE

Compliance with contract delivery/completion schedules including timely submission of data deliverables (If liquidated damages were assessed or the schedule was not met, please address below.)
Choose an item.
Comments:

3. COMMUNICATION

Contractor was reasonable and cooperative in dealing with client staff (including the ability to successfully resolve disagreements/disputes and responsiveness to client requests)
Choose an item.
Comments:

4. MANAGEMENT/ PERSONNEL/ LABOR

Effectiveness of management, including suppliers, materials, and/or labor force (including the ability to effectively lead, manage, and control the project)
Choose an item.
Continuity in the contractor’s personnel during execution of the contract (e.g., one person or team that stayed with the project throughout the contract)
Choose an item.
Comments:

5. COST/ FINANCIAL MANGEMENT

Ability to meet the terms and conditions within the contractually agreed price
Choose an item.
Comments:

6. SUBCONTRACT MANAGEMENT

Ability to manage subcontracting effort, including any subcontracting issues, and the contractor’s ability to resolve the problems without extensive customer guidance

Choose an item.

Comments:

7. SUMMARY

Would you hire or work with this firm again? If no, please explain below.
Choose an item.
Provide an overall rating for the work performed by this contractor.
Choose an item.

ADDITIONAL COMMENTS:

EVALUATOR SIGNATURE:
DATE:

ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

*THIS PAGE WILL BE REMOVED FOR EVALUATION PURPOSES AND NOT BE COUNTED TOWARD THE SF 330 PAGE COUNT – IT IS FOR PPQ COMPLETION PURPOSES ONLY*

Rating
Definition
Outstanding
The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective.
Above Average
The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Offeror were effective.
Satisfactory
The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Offeror were satisfactory.
Unsatisfactory
Performance did not meet contractual requirements. The contractual performance reflected a serious problem for which the Offeror has yet to identify corrective actions or the Offeror’s proposed actions appear only marginally effective or were not fully implemented.
Not Applicable
No information or did not apply to your contract.

image1.tiff

File details come from the government source that posted it. Updated .