-Past_Performance_Questionnaire.pdf

South Florida National Cemetery Gravesite Expansion

VA786A-14-R-0014

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire. Please email or mail to:

Department of Veterans Affairs National Cemetery Administration Contracting Service 425 I Street NW, 5Th Floor Washington D.C. 20001 Attn: Tiffany M. Thornton

Desired Response Date:

Email:tiffany.thornton@va.gov

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1. CONTRACTOR NAME & ADDRESS:

2. CONTRACT NO.:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

6. TYPE OF CONTRACT:

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.

O = Outstanding E = Excellent

A = Adequate M = Marginal

P = Poor N/O = Not Observed

A. Quality of Products and Services - Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

O E A M P N/O

B. Performance – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

C. Schedule – Assess the timeliness of contractor against the schedule of activities.

D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.

E. Cost Control – Assess the contractor’s ability to manage the contract budget and control costs.

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

G. Overall Assessment.

If an Award Fee contract, what was the average Award Fee % earned?