S02 Past Performance Questionnaire 36C10F23R0013.docx

36C10F23R0013 | PAST PERFORMANCE QUESTIONNAIRE (PPQ)

PAST PERFORMANCE QUESTIONNAIRE (PPQ) FOR 36C10F23R0013

Your assistance is requested in support of a source selection for this solicitation.

Please complete this Questionnaire and return it via email to by the closing date and time listed in the solicitation:

SUBJECT: FT. LOGAN PHASE 1A | 36C10F23R0013 | PPQ

TO: CONTRACT SPECIALIST, RACHEL BEASON AT RACHEL.BEASON@VA.GOV AND CONTRACTING OFFICER, DAVID BULLERWELL AT DAVID.BULLERWELL@VA.GOV

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

3. CONTRACT AWARD DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

1b. NAME OF PRIME CONTRACTOR (If this questionnaire is for a team member)

6. TYPE OF CONTRACT:

7. PROJECT TITLE, LOCATION, AND DESCRIPTION (AND TOTAL CONSTRUCTION VALUE AT PROJECT COMPLETION):

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION

a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER:

c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor and provide a brief description.

A. Quality of Products and Services – Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

E V/G S M U N/O

Note:

B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

E V/G S M U N/O

Note:

C. Schedule – Assess the timeliness of contractor against the schedule of activities.

E V/G S M U N/O

Note:

D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.

E V/G S M U N/O

Note:

E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.

E V/G S M U N/O

Note:

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

E V/G S M U N/O

Note:

G. Overall Assessment.

E V/G S M U N/O

Note:

Please provide any additional comments to support the ratings above: (for any ratings of E, V/G, S, M, or U, please provide some brief comments about strengths & weaknesses you observed in this contractor that help us understand your rating. Feel free to provide additional pages if necessary):

Signature: