1131PL26RQ0015 - Past Performance Survey.pdf

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INDO-PACIFIC ENERGY AND CRITICAL MINERALS PROJECT SCOPING SERVICES
Solicitation number
1131PL26R0015
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This is a Past Performance Survey template for Solicitation No. 1131PL26RQ0015, issued by the U.S. Trade and Development Agency (USTDA) for a Definitional Mission for South and Southeast Asia: Indo-Pacific Energy Opportunities. The survey is to be completed by agencies or organizations that have worked with contractors and must be submitted to USTDA's Office of Acquisition Management at Contractproposals@ustda.gov no later than 1:00 PM, March 30, 2026 (Arlington, VA Time).

The survey collects information about contractor performance across six key evaluation areas: compliance with contract terms and conditions, ability to complete work on schedule, compliance with actual requirements, ability to take appropriate corrective measures, willingness to recommend the contractor for future business, and any additional performance issues or comments. Respondents rate their confidence on a five-point scale ranging from Substantial Confidence to No Confidence for the first four questions, provide yes/no responses for the fifth question with space for explanatory comments if the answer is negative, and indicate whether additional issues exist for the sixth question. The form requires identification of the contractor being reviewed, submitting agency, contact information of the person completing the questionnaire, period of performance, brief service description, and total contract value. This is a template document designed to gather references on contractor past performance for evaluation purposes.

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Solicitation Definitional Mission for South and Southeast Asia: Indo-Pacific Energy Opportunities Definitional Mission Solicitation No.: 1131PL26RQ0015

PAST PERFORMANCE SURVEY

Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, March 30, 2026 Arlington, VA Time.

Name of Contractor Being Reviewed:

Contract Number/Reference Information:

Name of Agency/Organization Submitting Review for this Contractor:

Name of Person Completing Questionnaire Phone Number Email Address

Period of Performance: XX/XX/XXXX –

XX/XX/XXXX

Brief Description of Services: XXXXXXXXX

Total Contract Value: $XXXX.XX

Contract Performance Information

Questions: Response:

1. How would you rate your confidence in the contractor’s ability to comply with contract terms and conditions?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence � No Confidence

2. How would you rate your confidence in the contractor’s ability to complete work on schedule?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence � No Confidence

3. How would you rate your confidence in the contractor’s ability to comply with the actual requirements?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence � No Confidence

4. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence � No Confidence

5. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.

� Yes � No

Comment:

mailto:Contractproposals@ustda.gov

Solicitation Definitional Mission for South and Southeast Asia: Indo-Pacific Energy Opportunities Definitional Mission Solicitation No.: 1131PL26RQ0015

Questions: Response:

6. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss?

� Yes � No

Comment:

USTDA sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.

Additional Comments:

Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, March 30, 2026 Arlington, VA Time.
Period of Performance: XX/XX/XXXX – XX/XX/XXXX
Brief Description of Services: XXXXXXXXX
Total Contract Value: $XXXX.XX
Contract Performance Information

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