S02 Past Performance Survey.pdf
PDF 19 KB Posted
- Solicitation number
- 36C26122Q0427
About this file
This document contains a past performance survey template and details of a federal contract opportunity. The past performance survey is a template for references to evaluate a company's previous work, rating quality and addressing any performance issues.
The related federal contract opportunity is solicitation number 36C26122Q0427 for medical gases maintenance services for the VA Pacific Islands Health Care System. Services are needed for an unspecified period to maintain medical gases at VA facilities. Offerors must submit past performance surveys from references with their quotes. The soliciting agency is the Department of Veterans Affairs Veterans Health Administration VISN 21.
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Other files
| File | Type | Posted |
|---|---|---|
| S02 Self-Performance Worksheet Small Business.pdf | ||
| 36C26122Q0427_1.docx | DOCX document | |
| S02 - Wage Determination.pdf |
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Past Performance Survey
OFFEROR INSTRUCTIONS: A separate survey must be completed for each reference. The completed surveys must be included with the quote.
EVALUATOR INSTRUCTIONS: The Department of Veterans Affairs is considering the company listed below for award of a VA contract. Your comments would be appreciated regarding this company’s past performance. The name of the individuals providing reference information is confidential and will not be released or made publicly available.
Name of Company being evaluated:
Evaluator’s Name:
Evaluator’s Company Name, Address and Phone number:
Indicate what contracts did this company provided for you? Provide the total contract amount, dates of performance, and contract number.
Evaluation Questions Please rate the overall quality of work using a scale of (Excellent, Good, Fair, Marginal, Unacceptable). Comments in support of the rating are welcome.
Were there any performance issues/concerns? If so, how were they handled?
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