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This document is the ATTACHMENT A PERFORMANCE RELEVANCY SURVEY for the Tennessee Valley Healthcare System (TVHS) - VA Medical Centers (VAMC) Murfreesboro and Nashville, TN Multiple Award Task Order Contract (MATOC) Solicitation 36C24924R0004.

The survey requests that offerors provide information on up to three projects/contracts they believe are very relevant, relevant or not relevant to the MATOC solicitation. The survey asks for details on the offeror's role (prime or subcontractor), contract number, value, completion dates, and a description of the work performed, highlighting any technical areas unique to the solicitation. Offerors are also required to provide contact information for the government contracting officer and inspector. Additionally, the survey requests information on subcontractors to be utilized, any past liquidated damages, corrective actions taken on prior projects, and other past performance considerations such as value engineering proposals, awards/recognition, and unique skills/accomplishments.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 TVHS Multiple Award Task Order Contract (MATOC) 36C24924R0004

ATTACHMENT A

PERFORMANCE RELEVANCY SURVEY

PART 1: Provide the following information requested in this format for each of the projects/contracts you intend to have considered for evaluation. Projects may be on-going and cannot have been completed any later than 5 years prior to the proposal due date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you elect to reference.

A. Offeror (Your) Name (Company/Division):

B. Project/Contract Title:

C. Contract Specifics:

1. Description of Effort as __________Primeor______Subcontractor
2. Contract Number__________
3. Original Contract $ Value ________Current/Final Contract $ Value ____________
4. If amounts in 3 above are different, provide a brief description of the reason:
5. Completion Date(s):
a. Original Date: ______________________

b. Current Schedule____________________

c. Estimate/Final Completion Date:_____________________
d. Primary cause for Contract Modifications______________

D. Provide detailed description of the work performed under the contract and describe why you believe the work is VERY REVELANT, RELEVANT, or NOT-RELEVANT. Descriptions must address the following:

1. Describe the specific elements of the work performed by your firm.

2. Indicate what elements of work were performed by your primary subcontractors and indicate if those same subcontractors will be used on projects awarded under this MATOC. Should you intend to use these same subcontractors, please list their company names and described their principal areas of work that they will perform.

3. Address any technical areas about this project you consider uniquely relevant to this solicitation.

E. Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR / COTR); include a current phone number, email address and facsimile number for each.

Company Name:

Point of Contact:Title:E-mail:__
Office Phone:_______________Fax:_

Address of Record:

PART 2: Additional offeror information required, but not project specific. This information need only be provided once in your submission package.

A. Name subcontractors and/or Teaming Partners to be utilized on this contract. Multiple subcontractors may be named for the same discipline, but are limited to a maximum of three (3) subcontractors per discipline. As a minimum, provide the name(s) of subcontractors to be utilized in the following areas:

Plumbing

HVAC:

Electrical:

Roofing:

Testing, Civil Site Work:

Each primary subcontractor and/or Teaming Partner must also complete a Subcontractor Information and Consent Form to be considered.

Written references for subcontractors may be included and are encouraged. However, subcontractors do not need to send out questionnaires.

B. Provide information regarding the assessment of liquidated damages on any contracts within the last five years. (Frequency, circumstances, severity of problem, etc.)

C. Offerors are strongly encouraged to include with their proposals information on problems encountered on relevant projects and the specific corrective actions taken to remedy the problems.

D. Other Past Performance Considerations. Information provided, shall be limited to the period starting 5 years prior to the solicitation release date and may include the following:

1.Effectiveness of value engineering (VEC) proposals you submitted on prior contracts. (Provide abrief description; impact on cost, schedule, efficiency or quality; contract number; name andphone number of customer benefiting from the VEC).
2.Professional/Industry awards (Identify award type, date of award and copy of certificate ifapplicable), Letters of appreciation, recognition or commendations
3.Discuss unique skills and accomplishments (Explain unique skills and/or accomplishments andprovide supporting information for verification).

Company Name:

Point of Contact:Title:E-mail:__
Office Phone:_______________Fax:_

Address of Record:

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