Attachment 1 Past Performance Questionnaire.doc
DOC document 85 KB Posted
- Attached to
- GPO Electrical Panel Assessment
- Solicitation number
- 040ADV-24-R-0011
- Issued by
-
Government Publishing Office
About this file
This document contains a past performance questionnaire template to be completed by contractors and evaluating organizations. The questionnaire requests information on completed contracts including contract number, period of performance, completion date, value, type of contract, key characteristics, quality of products and services, overall performance, schedule, technical requirements, cost control, subcontracting, and customer satisfaction for both routine and unexpected difficulties. Space is provided to list contractor weak points, strong points, and other completed projects. For award fee contracts, it asks for the average award fee percentage earned.
The related federal contract opportunity is a solicitation to conduct an assessment of electrical panels in four Government Publishing Office buildings. The contractor will determine if the existing electrical panels comply with codes, identify any issues, and provide a cost estimate to upgrade main distribution panels, lighting panels, and other electrical panels to meet applicable NFPA safety standards. Proposals are due to the Government Publishing Office by February 20, 2023.
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Text version
Attachment 2
Past Performance Questionnaire
Past Performance Questionnaire
ORGANIZATION’S PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this questionnaire and send by email to: tmizelle@gpo.gov and cbettini@gpo.gov
U.S. Government Publishing Office Acquisition Services
732 North Capitol Street, NW Room A530, Stop: AS Washington, DC 20401 Response Due Date February 20, 2023 at 11:00 AM
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY CONTRACTOR
1. CONTRACTOR’S NAME AND ADDRESS
3. CONTRACT NO.:
CONTRACT DATE:
4. PERIOD OF PERFORMANCE:
4. PACE OF PERFORMANCE:
5. COMPLETION DATE:
6. CONTRACT VALUE $
2. PROJECT NAME:
7. TYPE OF CONTRACT:
8. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:
Please add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
9. NAME AND ADDRESS OF EVALUATING ORGANIZATION:
EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other)
EVALUATOR’S PHONE NUMBER
MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please check the response code for each topic that best reflects your experience with this Contractor:
EX = Exceptional VG = Very Good S = Satisfactory MG = Marginal US = Unsatisfactory N/O = Not Observed
Quality of Products and Services- Assess the Contractor’s conformance to contract requirements.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Overall Performance- Assess the Contractor’s overall performance for the project.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Schedule- Assess the timeliness of the Contractor against the schedule of activities (as appropriate).
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Technical Requirements- Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Cost Control- Assess the Contractor’s willingness and ability to manage the contract budget and control costs.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Subcontracting- Assess the Contractor’s success at complying with subcontracting goals.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Repeat Business- Assess the likelihood that you would want this Contractor to perform another contract for you in the near future.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
List Contractor’s Weak Points:
List Contractor’s Strong Points:
List any other projects this Contractor has completed for you:
If an award fee contract, what was the average award fee % earned?
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