VA770-17-R-0423-010.pdf

PAST PERFORMANCE QUESTIONNAIRE

Network Contracting Office 15/Consolidated Mail Outpatient Pharmacy (CMOP) is conducting a competitive acquisition for Document Printing and Insertion Services.

The offeror has identified you as a reference to validate the offeror’s past performance. Please complete the following questionnaire to assist our evaluation of the contractor’s past performance and return no later than 3:00 p.m. CDT, October 20, 2017 to Leah Thurman, NCO 15/CMOP, Fax 913-684-0179 or e-mail at leah.thurman@va.gov.

Name of Contractor being evaluated: _______________________________________________

1) How long has your company had this contract with this contractor? ____________________

2) Type of service being provided: ________________________________________________

3) Where is the service being provided? ____________________________________________

4) What is total value of this contract? _____________________________________________

5) Management Effectiveness

• Contractor provided experienced personnel with technical and administrative abilities to meet contract requirements.

Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

• Contractor maintained appropriate staffing levels (number/qualifications)

• Contractor’s overall management effectiveness

6) Quality of Service and Workmanship

• Contractor provided professional services

• Contractor maintained the quality of storage facilities

• Contractor’s overall quality of service

7) Timeliness/Adherence to Schedules

• Contractor transported your cargo within the timeframe as identified in your contract mailto:leah.thurman@va.gov

• Contractor was proactive in keeping you informed of schedule conflicts if they were going to occur

• Contractor responded to emergency requirements in a timely manner.

• Overall contractor timeliness

8) Quality/Training Control

• Contractor provided an adequate quality control plan to ensure reoccurring facility inspections during contact duration.

• Contractor adhered to its quality control plan and ensured the plan was available for review upon request.

• Contractor’s overall quality control

9) Customer Satisfaction

• Contractor maintained a professional working relationship

• Contractor was reasonable and cooperative in resolving customer complaints

• Contractor was flexible in responding to urgent requirements

• Overall customer satisfaction

10) Please provide any other examples or comments concerning the contractor’s performance that would be relevant in assessing the probability of successful contract performance:

Rating System:

Exceptional: Performance meets contractual requirements and exceeds many to the contractor’s benefit. The contractual performance was accomplished with few minor problems for which corrective action taken was highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the contractor’s benefit. The contractual performance was accomplished with some minor problems for which corrective action taken was effective.

Satisfactory: Performance meets contractual requirements. The contractual performance was accomplished with some minor problems for which corrective action taken appears or was satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has identified some corrective actions. The proposed actions appear only marginally effective or have not been fully implemented.

Unacceptable: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problems for which the contractor has identified corrective actions. The proposed actions appear or were ineffective.

Your Name: _____________________________Your Title: _____________________________

Your Phone #: ___________________________Your Fax: ______________________________

Your e-mail address: ____________________________________________________________