Attachment 5, Past Performance Questionnaire.pdf
PDF 279 KB Posted
- Solicitation number
- 12435H20Q0008
- Issued by
-
Department of Agriculture Forest Service
About this file
This document contains a past performance questionnaire and details of a federal contract opportunity for janitorial services. The past performance questionnaire is to be completed by a reference for a contractor and includes sections for contractor and reference information as well as a performance evaluation on areas such as contract performance, quality of service, and timeliness. The federal contract opportunity is a solicitation from the USDA Forest Service Blue Ridge Ranger District for janitorial services at recreation sites. It is set aside for small businesses with a size standard of $19.5 million and quotes are due by March 6, 2020. The contractor will provide supervision, labor, equipment, supplies and services to clean the sites in accordance with the performance work statement for the period of performance starting on or after March 20, 2020.
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PAST PERFORMANCE QUESTIONNAIRE (PPQ)
SECTION I: CONTRACTOR INFORMATION
A. Your Company Name and Address:
B. Phone /Fax #:
C. Point of Contact/email address:
D. Authorization is hereby granted to provide the information requested in SECTION II and III of this questionnaire.
Signature of Authorized Contractor Representative Date
Printed Name and Title of Authorized Contractor Representative
SECTION II: RESPONDENT INFORMATION: Request a reference from respondent by completing Section II and III and return to Contract Specialist, Seung (Josh) Choi.
A. Client/Reference Name and Address:
B. Phone/Fax #:
C. Point of Contact/email address:
D. Reference Contract Number:
Project Title Contract Value/Type:
Period of Performance:
How long have you worked with the contractor:
More detailed description of the work performed
E. Date completed:
SECTION III: PERFORMANCE EVALUATION
A. CONTRACT PERFORMANCE
1. Working relationship with your Company?
2. How well did the contractor provide experienced workers, managers and supervisors with the technical and administrative abilities needed?
A U
3. Did the contractor exhibit knowledge of and compliance with government (or other) regulations and industry standards?
4. How well did the contractor provide and properly maintain operational equipment throughout the term of the contract?
5. Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract?
6. How well did the contractor comply with Environmental, health, labor laws, safety and security requirements?
7. How well did the contractor coordinate and control subcontractors, if any? A U
8. Contractor’s Overall Performance A U
B. QUALITY OF SERVICE/CONTROL
1. Contractor’s accomplishment in meeting the quality standards A U
2. The contractor provided an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain.
3. Contractor identified and corrected deficient Work A U
4. Contractor’s Overall Quality of Workmanship A U
C. TIMELINESS OF PERFORMANCE
1. How well did the contractor comply with the contract schedule? A U
2. Did the contractor provide timely and accurate records, submittals, and/or reports? A U
3. How well did the contractor resolve any delays? A U
REMARKS: For ratings of unacceptable, please provide remarks to describe the reasons for the rating. If additional remarks are necessary, please attach an additional sheet.
| undefined: |
| B Phone Fax: |
| C Point of Contactemail address: |
| Date: |
| Printed Name and Title of Authorized Contractor Representative: |
| A ClientReference Name and Address 1: |
| A ClientReference Name and Address 2: |
| A ClientReference Name and Address 3: |
| B PhoneFax: |
| C Point of Contactemail address_2: |
| D Reference Contract Number: |
| Project Title: |
| Contract ValueType: |
| Period of Performance: |
| How long have you worked with the contractor: |
| More detailed description of the work performed: |
| 1: |
| 2: |
| 3: |
| E Date completed: |
| A CONTRACT PERFORMANCE: |
| 1 Working relationship with your CompanyRow1: |
| 2 How well did the contractor provide experienced workers managers and supervisors with the technical and administrative abilities needed A URow1: |
| 3 Did the contractor exhibit knowledge of and compliance with government or other regulations and industry standards A URow1: |
| 4 How well did the contractor provide and properly maintain operational equipment throughout the term of the contract A URow1: |
| 5 Did the contractor demonstrate the ability to hire maintain and replace if necessary qualified personnel during the contract A URow1: |
| 6 How well did the contractor comply with Environmental health labor laws safety and security requirements A URow1: |
| 7 How well did the contractor coordinate and control subcontractors if any A URow1: |
| 8 Contractors Overall Performance A URow1: |
| B QUALITY OF SERVICECONTROL: |
| 1 Contractors accomplishment in meeting the quality standards A URow1: |
| 2 The contractor provided an effective quality control plan or inspection procedures to meet contract requirements If no please explain A URow1: |
| 3 Contractor identified and corrected deficient Work A URow1: |
| 4 Contractors Overall Quality of Workmanship A URow1: |
| C TIMELINESS OF PERFORMANCE: |
| 1 How well did the contractor comply with the contract schedule A URow1: |
| 2 Did the contractor provide timely and accurate records submittals andor reports A URow1: |
| 3_2: |
| How well did the contractor resolve any delays: |
| A: |
| U: |
| remarks are necessary please attach an additional sheet 1: |
| remarks are necessary please attach an additional sheet 2: |
| remarks are necessary please attach an additional sheet 3: |
| Text1: |
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