S02 - Past Performance Questionnaire - Sample.pdf

PDF 691 KB Posted

Attached to
Z1DA--523A4-24-005 Design Build Replace EP Lab West Roxbury
Solicitation number
36C24123R0185
Issued by

About this file

This document contains a past performance questionnaire and cover letter for a federal contract opportunity with the Department of Veterans Affairs. The cover letter identifies the contract as Solicitation #36C24123R0185 for the design and build of a replacement electrophysiology lab at the West Roxbury VA Medical Center. The letter requests that the reference customer identified by the bidding company complete the attached past performance questionnaire and return it directly to the contracting officer at the VA by a specified date. The questionnaire is considered sensitive and is not to be released to the bidding company. Contact information is provided for the VA point of contact should the reference have any questions about the acquisition or questionnaire.

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Other files

File Type Posted
36C24123R0185 0001.docx DOCX document
RFI questions Phase I.docx DOCX document
P03 SSJ 523A4-24-005-Signed CO signed.pdf PDF
MA WD MA20230001.txt TXT text file
S02 Reference Drawing Existing.pdf PDF
S02 Typical DRAWINGS-Philips AZURION-New Equipment.pdf PDF
36C24123R0185.docx DOCX document
S02 523A4-24-005 SOW revised.docx DOCX document

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ATTACHMENT 1 - PAST PERFORMANCE QUESTIONNAIRE AND COVER LETTER

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) Solicitation # ________________for the “Insert Project Title, Number”. This solicitation requires respondents to identify customers and solicit their response regarding [Insert Company Name] performance if final CPARS ratings are not available for submitted projects.

[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 solicitstion instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire and email it by __PM EST on xx/xx/2023 directly to the NCO 1 Contracting Officer, Michael Muller at Michael.Muller@va.gov

E-mail: ____________________

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]

VHAPROPERINM

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POINT OF CONTACT POC Phone Number

LOCATION OF WORK: ADDRESS: CITY/STATE/ZIP

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