Attachment 6: Request for Proposals Offeror Past Performance Questionnaire Fillable

895350186181DEPARTMENT OF VETERANS AFFAIRS (VA)

ETMPM-TENS Procurement Program
Solicitation Number 36C79126R0011

Past Performance Questionnaire (PPQs)

Purpose: Offerors responding to Solicitation Number 36C79126R0011 shall submit up to three (3) CPARS Evaluation Reports when available. The Government Evaluators will validate the availability of CPARS Evaluation reports utilizing the Offeror’s System for Award Management (SAM.gov) Unique Entity Identifier (UEI) for any Offeror that utilizes a PPQ. When an Offeror cannot provide at least three (3) CPARS evaluation reports with effective dates in the past 24 - 36 months, the Offeror shall submit up to three (3) completed PPQs from recent/relevant Customers for similar medical device supply contracts. Note: Any combination of CPARS Evaluation Reports and PPQs shall be utilized to ensure that the Offerors’ proposal submission documentation includes three (3) past performance documents for Government evaluations. This is a material proposal submission requirement and may not be waived by the Government. Instructions For The Rater / Customer (How to complete this PPQ): Please provide information for contracts performed within the last three (3) years that demonstrate the Offeror’s capability to perform the medicaldevice supply work required under Solicitation Number 36C79126R0011. A separate Attachment 0006 shall be completed for each contract or order presented as a past-performance reference. Evaluate the Offeror’s performance as follows:

Scope & Period: Evaluate the Offeror’s performance during the most recent 24–36 months of the referenced contract(s), addressing device quality, delivery timeliness, warranty/RMA support, customerservice responsiveness, labeling and traceability, and regulatory compliance.

Adjectival Ratings: Select one rating for each evaluation area (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or N/A) and provide narrative evidence supporting each rating. CPARS definitions and standards apply.

Numeric Mapping: Each adjectival rating has a numeric equivalent (5 = Exceptional; 4 = Very Good; 3 = Satisfactory; 2 = Marginal; 1 = Unsatisfactory; N/A = No Score). This mapping assists the VA evaluation team but does not replace qualitative judgment under FAR 15.305 and FAR 15.308. Narratives Are Mandatory: A supporting narrative is required for every substantive rating. For an N/A selection, the Rater should briefly state why the area is inapplicable. Every selected rating must include a detailed narrative describing specific performance evidence such as dates, quantities, defect rates, timeliness statistics, corrective actions, and measurable outcomes. Ratings without narratives cannot be used.