1202SC26Q2707 Attachment 4 Past Performance Questionnaire.pdf

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Attached to
Request for Quote for Pump Attachments Compatible with WATERAX MARK-3 and Mercedes Textiles Wick Fire Pumps
Solicitation number
1202SC26Q2707
Issued by

About this file

This document is a Past Performance Questionnaire template for use in evaluating contractor performance on Solicitation 1202SC26Q2707 for Pump Attachments issued by the USDA/US Forest Service Incident Procurement Operations (IPO) for the National Interagency Fire Center (NIFC) in Boise, Idaho.

Section A of the questionnaire is completed by the prospective contractor and contains contractor identification information, contract details, and assessor contact information. The contractor must provide this document to each assessor and submit copies of Section A with the proposal by the solicitation closing date. Contractors are required to obtain authorization from an authorized official before distributing the questionnaire to assessors. Section B is completed by assessors knowledgeable of the contractor's past performance and must be submitted directly to the Contract Specialist at shannon.meadows@usda.gov by Friday, June 19, 2026, by 5:00 PM Eastern Daylight Time. Assessors are instructed not to send completed questionnaires back to the contractor being evaluated.

The evaluation criteria in Section B assess contractor performance across three categories: Quality of Service (compliance with contractual requirements and quality of goods/services); Schedule (timely delivery and cost control with complete, accurate, and timely invoices); and Business Relations (business practices, working relationships, timeliness of required reports, and responsiveness to complaints). Assessors rate performance as either Acceptable or Unacceptable and must provide rationales for any unsatisfactory or marginal ratings. The questionnaire also requests an overall assessment of whether the assessor would recommend awarding another contract to the contractor and an overall performance rating covering quality, schedule, and business relations combined.

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Solicitation 1202SC26Q2707 USDA/US Forest Service Pump Attachments Incident Procurement Operations

ATTACHMENT 4: PAST PERFORMANCE QUESTIONNAIRE

SUBJECT: Past Performance Questionnaire for 1202SC26Q2707 for Pump Attachments NFES 0145 hand primer, NFES 0228 check and bleeder valves, and NFES 0229 pressure relief valves.

PAST PERFORMANCE INSTRUCTIONS

The USDA/US Forest Service, Incident Procurement Operations (IPO), At Incident Management Support (AIMS) Logistics Contracting Branch, Boise, ID, has issued a solicitation for a Purchase Order (PO) for the National Interagency Fire Center (NIFC) located in Boise, ID.

Past performance information will be used to evaluate proposals received. Section A is to be completed by the Offeror. Section A of the enclosed questionnaire lists the contractor who has identified your office as a source to evaluate their past performance. Section A also authorizes release of this information to the PPS, IPO, and NIFC.

The Offeror must provide this entire document to each of its assessors. The Offeror shall only submit with its proposal (by the closing date of the Solicitation) copies of Section A of the questionnaire as provided to the assessors.

Section B in its entirety is to be completed by the assessor(s). An individual assessor knowledgeable of the contractor’s quality of services rendered is requested to verify, complete the questionnaire, and submit to the Contract Specialist listed below. If evaluating more than one contract for the same contractor, use a separate questionnaire for each contract being evaluated.

Because this information is critical to the evaluation process, your time and effort in providing your assessment is greatly appreciated. The questionnaire should be completed as soon as possible but not later than Friday, June 19, 2026, by 5:00 PM Eastern Daylight Time.

Assessor is requested to send electronically to shannon.meadows@usda.gov.

*Assessor: Please do not send this information to the Offeror being evaluated.

Thank you in advance for your cooperation and expeditious response to this request.

mailto:shannon.meadows@usda.gov

PAST PERFORMANCE QUESTIONNAIRE

SECTION A: Contractor Information (to be completed by the contractor for whom past performance information is being collected, prior to forwarding to assessors)

Solicitation Number 1202SC26Q2707 Requisition Pump Attachments Agency/Customer USFS/National Interagency Fire Center

1. Prospective Government Contractor’s______________________________________ Name and Address: ______________________________________

2. Contractor Point of Contact: _____________________________________________

3. Phone number (with area code):___________________________________________

4. Assessor Contract Award number:_________________________________________

5. Description of Services provided under contract:

6. Contract award date: ___________ Contract Amount: Initial ___________Final ____

7. Period of Performance or Delivery Date: ____________________________________

ASSESSOR INFORMATION:

Assessor Name Title Phone Number/Email Address

8. Authorization is hereby granted to provide the information requested in this questionnaire to USFS/National Interagency Fire Center, Contracting Office, Boise, Idaho.

(Signature)

(Name and Title of Authorizing Official) (Date)

SECTION B: Assessor’s Information (to be completed by assessors).

RATING SCALE Definitions

Past Performance Evaluation Ratings

Rating Description

Acceptable (A) Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown.

Unacceptable (U) Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

The questions on the survey (see below) shall be rated in accordance with the definitions provided in the Rating Scale. Any unsatisfactory or marginal rating shall be supplemented with an explanation in the space provided.

QUALITY OF SERVICE

1. Rate the contractor’s compliance with contractual requirements. A U

2. Overall rating of contractor quality of goods/services. A U

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

SCHEDULE

1. Delivery was within required time period specified by contract requirements. A U

2. Rate the contractor’s ability to control cost and submit invoices.

Are invoices complete, accurate, and timely? A U

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

BUSINESS RELATIONS

1. Overall rating of contractor’s business practices (e.g. maintaining a positive working relationship, business ethics, timely and effectively resolving any problems, etc.) A U

2. Rate the working relationship between contractor’s management, and your company (i.e. contractor’s history of reasonable and cooperative behavior, commitment of customer satisfaction; concern for the interest of the customer). A U

3. Rate the contractor's ability to submit required reports and/or invoices in a timely manner. A U

4. Rate the contractor’s responsiveness to customer complaint resolution. A U

5. Overall rating of contractor’s business relations. A U

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

How would you feel about awarding another contract to this contractor?

______ Would not hesitate to award another contract to this contractor.

______ Would most likely award another contract to this contractor.

______ Would think twice about awarding another contract to this contractor but would do so if no better alternative existed.

______ Do not wish to award another contract to this contractor.

______ Would not award another contract to this contractor.

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Overall Rating of Contractor’s performance (quality, schedule, business relations,) on contract being assessed.

Acceptable Unacceptable

VII. General Comments:

ASSESSOR:

Identify your role in the contract award or administration and the period of your involvement.

Role Period of Involvement Contract Specialist/Contracting Officer Technical Project Lead/Project Officer

OTHERS

(Signature) (Date)

(Typed or Printed Name) (Organization Name)

(Phone Number) (Organization)

Assessor Name

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