Exhibit B

EXHIBIT B

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS TO CONTRACTOR

Complete the CONTRACTOR INFORMATION section, below (type answers into light blue shaded boxes). Save the document. Send an electronic or hard copy print of the form to each of your reference contacts, asking them to please complete the form and submit it according to the instructions, below.

INSTRUCTIONS TO REFERENCE CONTACT

The contractor named below is submitting an offer for a United States Department of Veterans Affairs contract requirement, and has sent this form to you, in your role as a past performance reference contact. Please complete this form in full (all areas shaded in light yellow, below). Once completed, please send the form to the Contract Specialist via email, directly to: Attention Andrew Misfeldt. Email Address: [email protected] Please return the completed form no later than the time set for receipt of proposals. If you have any questions, please contact Andrew Misfeldt via email. Thank you for your assistance in this matter. GENERAL INFORMATION [completed by Contractor]
Contractor Company Name
Street Address
Contractor Point of Contact Name
City
Point of Contact Phone Number
State
Reference Project Title
Zip Code
Contract Period of Performance (start to finish):
Email
Contract Number
Contract Dollar Value
Description of Work
Role of Contractor on This Project (check appropriate box) ☐ Prime Contractor ☐ Sub-contractor ☐ Key Personnel

RESPONDENT INFORMATION [completed by Reference Contact]

Company Name
Street Address
POC Name
City
Phone Number
State
Fax Number
Zip Code
Email
PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2 in the Remarks section, below (text box will expand to whatever extent is necessary).

UNSATISFACTORY

MARGINAL

SATISFACTORY

VERY GOOD

EXCEPTIONAL

NEUTRAL

Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective. Performance met contractual requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory. Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.