S02 - ATTACHMENT 7 - Past Performance Questionnaire.docx
DOCX document 21 KB Posted
- Solicitation number
- 36C77621R0041
About this file
This document contains a past performance questionnaire template for evaluating offerors for a COVID-19 pandemic response and scenario planning contract opportunity with the Department of Veterans Affairs. The contract will be awarded on a single-award, firm-fixed-price basis to provide pandemic response and scenario modeling planning support. The past performance questionnaire requests ratings and comments on an offeror's quality of working relationships, professionalism, responsiveness, ability to manage projects, communication levels, quality control, and whether the evaluator would award another contract. Evaluators are asked to return completed questionnaires by the proposal due date to assist in contract award evaluation.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77621R0041 0002.docx | DOCX document | |
| S02 - ATTACHMENT 1 - REVISED_COVID-19 Pandemic Response PWS.docx | DOCX document | |
| 36C77621R0041_1_Price Schedule .docx | DOCX document | |
| 36C77621R0041 0001.docx | DOCX document | |
| S02 - ATTACHMENT 2 - Travel Authorization Request.doc | DOC document | |
| S02 - ATTACHMENT 1 - COVID-19 Pandemic Response PWS .docx | DOCX document | |
| 36C77621R0041_1.docx | DOCX document | |
| S02 - ATTACHMENT 6 - Quality Assurance Surveillance Plan.doc | DOC document | |
| S02 - ATTACHMENT 5 - Contractor Staff Roster.doc | DOC document | |
| S02 - ATTACHMENT 8 - Subcontracting Plan Template.docx | DOCX document | |
| S02 - ATTACHMENT 3 - TMS User Request.doc | DOC document | |
| S02 - ATTACHMENT 4 - Contractor Personnel Change Form.doc | DOC document | |
| S02 - ATTACHMENT 9 - PWS Attachment - COVID-19 Project Template.pdf |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
The Department of Veterans Affairs, Veterans Health Administration - Program Contracting Activity – Central (PCAC) is considering the Offeror listed below for award of a contract to provide COVID-19 Pandemic Response and Scenario Planning for the Veterans Health Administration.
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 complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. In addition to submitting this questionnaire, the PCAC may contact you in order to obtain any additional information regarding a contract award.
Please email your completed questionnaire to Kymberly Morgan at Kymberly.Morgan@va.gov no later than the date proposals are due.
**All Email Correspondence for this project must reference the RFQ Number, Project Identifier and Project Title in the subject line of the email: 36C77621R0041, COVID-19 Pandemic Response
If you have questions regarding the attached questionnaire, or require assistance, please email Kymberly Morgan at Kymberly.Morgan@va.gov.
Past Performance Information:
Name and Address of Company (Offeror) being evaluated:
Contract Number/Delivery or Task Order Number, Title, & Location of project the Offeror performed:
Evaluator: (The following information will assist in the analysis of the data. Information will be kept confidential)
Name of Evaluator:
Address:
Phone Number:
Position held or function in relation to project:
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. |
| “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 U
2. The professionalism and integrity with which offeror conducted business.
O A S U
3. The responsiveness to the client’s needs and expectations.
O A S U
4. The Offeror’s ability to manage and perform the project successfully.
O A S U
5. The offeror’s level of communication.
O A S U
6. The quality control of the project.
O A S U
7. Would you award another contact to the party being evaluated? If no, please explain.
Yes No
8. The delivery of the project was on schedule.
O A S U
9. Overall rating for this firm:
O A S U
Signature of Evaluator
Date
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