Attachment D.6 - Past Performance Questionairre

Attachment D. – PAST PERFORMANCE QUESTIONNAIRE

RFQ# 36C24826Q1057- 3D Image Reconstruction and Case Planning Services - Malcolm Randall VA Medical Center (VAMC), North Florida/South Georgia VA Healthcare System (OVAHCS) (Volume 3 Past Performance) PAST PERFORMANCE QUESTIONNAIRE Solicitation: 36C24826Q1057 – 3D image Reconstruction and Case Planning Services Department of Veterans Affairs (VA)
Malcom Randall VA Medical Center (VAMC)
North Florida/South Georgia VA Healthcare System (OVAHCS) Network Contracting Office - 8
Message to the assessor: Your assistance is requested by Jayne Messer, the VA Contracting Officer, to assist with establishing the performance history for the Company (Quoter) named below for which this Past Performance Questionnaire is being completed. In efforts to expedite receipt of the requested information, the Contracting Office respectfully requests that you do not mail hard copies. Instead, please e-mail the completed past performance questionnaire to jayne.messer @va.gov. If there is not enough space is provided, please attach additional information/pages to this questionnaire. Please return the past performance questionnaire on or before the closing date of the solicitation 10/12/202.

1. Name of Offeror:

Contract #

Based upon the definitions below, indicate your assessment of the offeror’s performance. Your assessment should consider the offeror’s performance in accordance with the contractual requirements. Please include the period of performance (POP) and contract value:
EVALUATION: Please rate the offeror using the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed. Rate by placing an (X) in the appropriate rating box.
Assessment

Definition

Outstanding (O)

The Offeror’s performance met contractual requirements and exceeded many requirements to the Client’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the offeror were

Above Average (A) The Offeror’s performance met contractual requirements and exceeded some requirements to the Client’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the offeror were effective. Satisfactory (S)

Unacceptable (U)

The Offeror’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by