ATTACHMENT C - FACTOR 3 - Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

VA Northern California Health Care System
Mather, CA

The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting quotes in response to the 36C26127Q0029 – Project No. 612A4-CSI-002, Construct Modular Imaging Center at the VA McClellan, CA 95652. The information you provide will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s). Please complete all sections of the attached questionnaire. Include your name and title, organizational address, e-mail address, telephone and fax number. Include the contractor’s name, your point of contact (POC,) the title and/or description of the type of work performed the award number, the value of the contract, the award and completion date of the project and the type of award. Use the attached rating scale rate each performance element. Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments. Clear handwritten responses are sufficient. Due to time constraints, it is important that the questionnaire be completed and returned by the date and time the quote is due in the solicitation. Please e-mail your response with the solicitation documents to the following email addresses:

David Rovner, Contract Specialist – Construciton Branch I at email: [email protected] . Charee Harris, Contracting Officer - Construction Branch I at Email: [email protected] .

Thank you for your time and participation.

PAST PERFORMANCE RATING SCALE

RATING:

DEFINITION:

USAGE:

EXCEPTIONAL

Performance exceeded many contractual requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective. An EXCEPTIONAL rating is appropriate when the contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit however could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified

GOOD

Performance exceeded some contractual requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were effective.