Attachment 2 - VAP Past Performance Questionnaire.pdf

PDF 181 KB Posted

Attached to
Family Advocacy Program (FAP) Victim Advocacy Program (VAP) and Emergency Placement Care (EPC) Support Services
Solicitation number
W564KV-25-R-A002
Issued by

About this file

The document is a Performance Assessment Questionnaire designed to evaluate a contractor's past performance for a federal contract opportunity. The questionnaire provides a structured framework for assessing contractor performance across multiple dimensions, including compliance with specifications, project management effectiveness, timeliness of deliverables, and commitment to customer satisfaction. The rating scale ranges from "Substantial Confidence" to "No Confidence", with each rating requiring a detailed rationale to support the evaluation.

The questionnaire is part of the procurement process for the Family Advocacy Program (FAP) Victim Advocacy Program (VAP) and Emergency Placement Care (EPC) Support Services, solicitation number W564KV-25-R-A002, issued by the Department of the Army Materiel Command Army Contracting Command. The document is to be completed by a point of contact familiar with the contractor's performance, with instructions to provide candid and factual responses that will be used in awarding federal contracts. The completed questionnaire should be returned to Contracting Officer Carlos Mayorga and Contract Specialist Jessica Spencer via their Army email addresses.

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Text version

PERFORMANCE ASSESSMENT QUESTIONNAIRE

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does (and/or) notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer Carlos Mayorga at carlos.a.mayorga.civ@army.mil and Contract Specialist Jessica Spencer at jessica.r.spencer2.civ@army.mil within the stated timeframe requested.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

mailto:carlos.a.mayorga.civ@army.mil mailto:jessica.r.spencer2.civ@army.mil

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence

Rationale: _________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

D. Reserved

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

F. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer Carlos Mayorga at carlos.a.mayorga.civ@army.mil and Contract Specialist Jessica Spencer at jessica.r.spencer2.civ@army.mil.

Thank you for your assistance.

mailto:carlos.a.mayorga.civ@army.mil mailto:jessica.r.spencer2.civ@army.mil

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