S02 Past Performance Questionnaire .docx

ATTACHMENT 1 - PAST PERFORMANCE QUESTIONNAIRE AND COVER LETTER

Complete one set of letters and forms for at least three projects identified in your firm’s Section F of the SF 330, which will best illustrate proposed team’s qualifications for this contract. Additional space or blank sheets may be added to answer any question.Transmittal letter to accompany Past Performance Questionnaire

FROM: [Insert Company Official Name, Title, and Company Name] SUBJECT: Past Performance Questionnaire for Contract(s):

[Insert Company Name] is currently responding to the Department of Veterans Affairs (NCO 1) request for SF 330 request for SF 330, Architect-Engineer Qualifications for the 689-24-115 A-E Bulk Oxygen Tanks Site Prep project. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance.

[Insert Company Name] is providing past performance data to NCO 1 relating to our performance on contract [Insert contract name/number] and have identified [Insert name of reference] as the point of contact for this contract.

The request for SF 330 instructs that respondent provide customers with the attached questionnaire. Please complete the questionnaire and email it by 4:00PM EST on February 23, 2024, directly to the NCO 1 Contracting Office.

E-mail: tamye.molinaro@va.gov The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to [Insert Company Name]. Please direct any questions about the acquisition or the attached questionnaire to the VISN 1 NCO point of contact identified above.

Thank you, [Insert Company Official Name and Title]

A. GENERAL INFORMATION

A-E FIRM TO BE EVALUATED:

Firm Name: Address:

Telephone: Email address: Point of Contact:

Firm Cage Code: Firm Tax ID Number: Firm DUNS Number:

Project Title:

Description of Project:

Description of A-E Firms’ Responsibilities:

Contract Number: Dollar Amount:

Contract Period of Performance:

The A-E Firm performed as the Prime Contractor Sub-Contractor/Consultant/Team Member

Percent of work performed by A-E Firm: Other (Please describe)

B. EVALUATOR INFORMATION:

Evaluator’s Company or Agency Name: Address:

Evaluator’s Name: Title of Evaluator: Telephone: E-mail:

C. SEND COMPLETED QUESTIONAIRE (SECTIONS B through D) TO:

Email: tamye.molinaro@va.gov

D. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Marginal or Unsatisfactory on page 7 under Narrative Summary.

effective or

corrective actions actions.

taken were effective.

A-E FIRM’S NAME: PROJECT NAME:

Contract Period of Performance:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix on page 4.

Item

FACTORS TO BE RATED

Design Services:

Follow-On Construction Support Services:

Item

FACTORS TO BE RATED

LEED (If Applicable):

BIM (If Applicable):

Owner’s Representative on Design/Build Projects (If Applicable):

Overall:

Number of A/E Design Errors & Omissions on Project:

Increased Project Cost Due to A/E Design Errors & Omissions:

CONTRACTOR’S NAME: PROJECT NAME

Contract Period of Performance:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

NARRATIVE SUMMARY (Use this section to explain any rating from the previous page)