S02 - Attachment 4 - Past Performance Questionnaire.docx

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Attached to
C1DZ--630-520 Design Convert Auditorium for Expansion of CBOC and Renovation of Primary Care Module (VA-21-00005300)
Solicitation number
36C77621R0028
Issued by

About this file

This pre-solicitation notice seeks SF 330 submissions from firms for design services related to the Convert Auditorium for Expansion of CBOC and Renovation of Primary Care Module project at the St. Albans, NY VAMC. Firms must submit one SF 330 package electronically by January 18, 2021 at 4PM Eastern containing required registration and licensing information. The two-phase selection process will evaluate submissions based on specialized experience, professional qualifications, capacity, past performance, locality knowledge, and construction period experience. Discussions will be held with the highest rated firms. The projected $10-20 million design-build contract is 100% set aside for SDVOSB concerns. The design contract award is anticipated by April 2021 for a 400-day performance period. The VA intends to award a firm-fixed price contract for architectural and engineering services including structural, mechanical, electrical and other disciplines to develop construction documents for the St. Albans medical facility project.

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ATTACHMENT 4 - PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Information

Firm Name:

Address:

Phone Number:

Point of Contact:

Contact Phone Number:

DUNs Number:

2. Work Performed as: |_| Prime Contractor |_| Sub Contractor |_| Joint Venture |_| Other

Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: |_| Firm Fixed Price |_| Cost Reimbursement |_| Other (Please specify):

Contract Title:

Contract Location:

Project Description:

Complexity of Work |_| High |_| Med |_| Routine Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT RATE ON A “+” OR “-“ SCALE. If a “+” or “-“ is used, the rating without the "+" or "-" will be applied. In addition to the ratings, please provide a short narrative in the appropriate block or in the remarks section of this form.

“O”
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.
“A”
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.
“S”
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.
“M”
Marginal
Performance did not meet some contractual requirements. Performance indicated that there are some potential risks associated with the quality products, timeliness of service, and contract performance.
“U”
Unacceptable
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.

Please rate and provide any supporting information/comments for the following:

1. The quality of the working relationship with the client (the tenant and/ or owner).
O A S M U
2. The professionalism and integrity with which offeror conducted business.
O A S M U

3. The responsiveness to the client’s needs and expectations.

O A S M U

4. The Offeror’s ability to successfully management and perform the project.
O A S M U
5. The offeror’s level of communication.
O A S M U
6. The quality control of the project.
O A S M U

7. Any Value added to the project as the result of cost savings, favorable financing, positive asset management, etc.

Yes No

8. Would you award another contact to the party being evaluated? If no, please explain.
Yes No
9. The delivery of the project within the budget and on schedule.
O A S M U

10. Other relevant aspects in the management of a project development for the client.

11. Overall rating for this firm:
O A S M U

Signature of Evaluator

Date

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