S03 SECT D ATTACH 2 PERFORMANCE QUESTIONAIRE 36C24825R0096.docx
DOCX document 24 KB Posted
- Attached to
- S205--Solid Waste Removal Renewal AMENDMENT 0001
- Solicitation number
- 36C24825R0096
About this file
This document is a Past Performance Questionnaire for a Solid Waste Removal Service federal contract opportunity (RFP #36C24825R0096). The solicitation is issued by the Department of Veterans Affairs Network Contracting Office 8 for the James A. Haley VA Hospital in Tampa, FL, seeking a Service-Disabled Veteran-Owned Small Business (SDVOSB) to provide non-hazardous solid waste collection services. The contract will cover a base period of one year with four additional one-year option periods, running from 07/01/2025 to 06/30/2030, with a Firm Fixed Price, Indefinite Delivery contract type.
The questionnaire is designed to gather comprehensive past performance information from previous clients, with detailed evaluation criteria across multiple performance dimensions including technical performance, contract management, quality control, safety, workforce capabilities, and responsiveness. Clients are asked to rate the contractor's performance using an adjectival rating system ranging from Excellent (E) to Poor (P), with specific focus areas such as ability to meet quality standards, compliance with contractual terms, effectiveness of management, and problem resolution capabilities. The completed questionnaire will be directly submitted to Kim Tucker at Kim.Tucker1@va.gov and will be used to assess the contractor's potential performance risk.
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Text version
SOLICITATION RFP #36C24825R0096
RFP – SECTION D - ATTACHMENT 2
PAST PERFORMANCE QUESTIONNAIRE
SOLID WASTE REMOVAL SERVICE
PAST PERFORMANCE QUESTIONNAIRE - COVER SHEET
The entire questionnaire should be forwarded to your previous clients for completion and clients shall directly return the cover sheet and questionnaire to Kim Tucker at e-mail address: Kim.Tucker1@va.gov It is your responsibility to ensure correct and verifiable point of contact information. Information that is incorrect or unverifiable may lead to a lower past performance rating.
(Offeror Fill-In Below)
1. Offeror Name (Name of Organization/Firm being Evaluated):
2. Name of Organization/Firm Providing Reference:
3. Address of Organization/Firm Providing Reference:
4. Contract Number:
5. Project Description:
6. Contract/Task Order Amount:
7. Performance Period:
ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
| E (EXCELLENT) |
| Performance meets contractual requirements and exceeds expectations. The contractual performance of the element assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. (High Confidence). |
| G (GOOD) |
| Performance meets contractual requirements and exceeds some requirements. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. (Significant Confidence). |
| S (SATISFACTORY) |
| Performance meets contractual requirements. The contractual performance of the elements contains some minor problems for which corrective action taken by the contractor is satisfactory. (Confidence). |
| M (MARGINAL) |
| Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented. (Little Confidence). |
| P (POOR) |
| Performance does not meet most contractual requirements and recovery is no likely in a timely manner. The contractual performance of the element contains serious problems for which the contractor’s corrective actions appear or were ineffective. (No confidence). |
| NR (NO RATING) |
| No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative or positive assessment). |
EVALUATOR: PLEASE “X” or CIRCLE THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
| Was this a competitive contract? |
| ___ YES ___ NO |
| Role of the contractor |
| ___ Prime Contractor or |
___ Subcontractor
| Ability to meet quality standards specified for technical performance |
| __E __G __S __M __P __NR |
| Compliance with contractual terms and conditions |
| __E __G __S __M __P __NR |
| Quality/integrity of technical data/report preparation efforts. |
| __E __G __S __M __P __NR |
| Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirement. |
| __E __G __S __M __P __NR |
| Effectiveness of overall contract management (including ability to effectively lead, manage, and control the project.) |
| __E __G __S __M __P __NR |
| Effectiveness of on-site management and control of multidiscipline construction categories, including management of subcontractors. |
| __E __G __S __M __P __NR |
| Contractor was reasonable and cooperative in dealing with staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports). |
| __E __G __S __M __P __NR |
| Timeliness/effectiveness of contract problem resolution without extensive customer guidance. |
| __E __G __S __M __P __NR |
| Ability to successfully respond to emergency situations. |
| __E __G __S __M __P __NR |
| Effectiveness of material management. |
| __E __G __S __M __P __NR |
EVALUATOR: PLEASE “X” or CIRCLE THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
| Contractor proposed innovative alternative methods that reduced cost, improved maintainability or other factors that benefited the client. |
| __E __G __S __M __P __NR |
| Contractor Safety Record. |
| __E __G __S __M __P __NR |
| Contractor responsiveness to safety issues. |
| __E __G __S __M __P __NR |
| Contractor’s timeliness, completeness, and accuracy in submitting invoices. |
| __E __G __S __M __P __NR |
| Ability to hire and retain a qualified workforce to this effort. |
| __E __G __S __M __P __NR |
| If this was a Government contract has the contract been terminated for default or Convenience? Indicate if show cause or cure notices were issued or any default action in the comment section below. |
| __E __G __S __M __P __NR |
| Have there been any indications that the contractor has had any financial problem? |
| __E __G __S __M __P __NR |
EVALUATOR COMMENTS:
EVALUATOR’S POINT OF CONTACT INFORMATION:
SIGNATURE: ____________________________________________________
EVALUATOR NAME: _______________________________________________
EVALUATOR TITLE: ________________________________________________
E-MAIL ADDRESS: ___________________________________________________
PHONE NUMBER: ___________________________________________________
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