Past performance questionnaire.pdf
PDF 1 MB Posted
- Attached to
- Medical Support Services for TNARNG
- Solicitation number
- W912L720R0005
About this file
This document includes a past performance questionnaire for offerors and details of a related federal contract opportunity for medical support services. The Tennessee Army National Guard is seeking proposals for medical support at four locations in Tennessee, with services to begin in June 2020. Offerors must submit a past performance questionnaire to be completed by references and returned by July 9th, 2020 to be considered for this firm fixed-price, 8(a) competitive set-aside contract with a NAICS code of 541611. Interested parties must register in SAM.gov and submit representations and certifications online to receive the full solicitation when issued.
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Other files
| File | Type | Posted |
|---|---|---|
| W912L720R0005-P0002 Amendment 2.pdf | ||
| PWS Attachment 0001 HIPAA.rtf | RTF text file | |
| W912L720R0005-P0001 Amendment 1.pdf | ||
| Proposal Spreadsheet Pricing Information.xlsx | XLSX spreadsheet | |
| Solicitation W912L720R0005 Medical Support Services.pdf |
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Text version
DEPARTMENT OF THE ARMY AND AIR FORCE
JOINT FORCE HEADQUARTERS
TENNESSEE NATIONAL GUARD
HOUSTON BARRACKS, POST OFFICE BOX 41502
NASHVILLE, TENNESSEE 37204-1502
NGTN-PFO-P 9 June 2020
SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal
(RFP) W912L720R0005
Dear Sir/Ma’am, The US Army Tennessee Army National Guard (TNARNG) is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to the North American Industry Classification System [NAICS] 541611. You have been identified as the point of contact cited on the enclosure.
Your assessment of their performance is extremely valuable to our evaluation.
Please complete the enclosure and return to the USPFO- TN Purchasing and Contracting Office, no later than 15 days after receipt of request or (09 July 2020), whichever occurs first. Submit your completed questionnaire to sinamar.b.benauro.civ@mail.mil.
Your cooperation is greatly appreciated. Questions may be directed to the undersigned at 615-313- 2658, e-mail address: teresa.a.baxter.civ@mail.mil
Sincerely, Teresa Baxter Teresa Baxter Contracting Officer
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 identified in the cover letter within the stated timeframe.
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)
Contractor/Company Name/Division:
Address:
Program Identification/Title:
Contract Number:
A. CONTRACT IDENTIFICATION
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:
Total Contract Value:
Name:
Title:
Date:
Telephone Number:
Address:
E-mail Address:
PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.
Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence
Rationale:
Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence
Rationale:
B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE
A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship
B. Effectiveness of Project Management (to include use and control of subcontractors).
Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence
Rationale:
Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence
Rationale:
Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence
Rationale:
Comments:
C. Timeliness of Performance for Services and Product Deliverables.
D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).
E. Commitment to Customer Satisfaction and Business-like Concern for its
Customers’ Interest
F. General Comments. Provide any other relevant performance 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:
Organization:
Name:
Title:
Date:
Telephone Number Address:
E-mail Address:
PART III. RETURN INFORMATION
Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.
Thank you for your assistance.
G. Other Information Sources. Please provide the following information:
H. Respondent Identification. Please provide the following information:
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