Past_Performance_Questionnaire.docx

Nav Aids Solicitation 1294TZ18Q0007

ATTACHMENT

SOURCE SELECTION SENSITIVE WHEN COMPLETED

**NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS**

PAST PERFORMANCE QUESTIONNAIRE

US Department of Agriculture, US Forest Service, Region 3 – Western Zone Contracting is considering the firm listed below. Your comments would be appreciated regarding this firm’s past performance.

CONTRACT INFORMATION (Evaluated Contractor to complete this section)

Name and Address of Firm Being Evaluated:

Work Performed as: ____ Prime Contractor ____Subcontractor Percent of Project Work Performed _____% Description of the Work Performed _____________________________________________________

Initial Amount: Final Amount:

CLIENT INFORMATION (Client to complete this section)

Name of Evaluator:

Company/Agency Name:

Address:

Phone Number:

Email Address:

Position Held or Function in Relation to Project:__________________________________________________

Signature___________________________________________ Date________________________________

RATINGS: If the rating is “Unacceptable”, please provide additional information in the Remarks section of this form.

“N/A” Not Applicable

Please circle the appropriate rating and provide any supporting information for the following:

1. QUALITY:

customer guidance.

E VG S M U

Contractor being evaluated______________________________________________ Client: _______________________________________________________________

2. SCHEDULE/TIMELINESS OF PERFORMANCE

3. CUSTOMER SATISFACTION

Including the ability to successfully resolve disagreements/disputes

E VG S M U

With the interests of the customer

E VG S M U

4. MANAGEMENT/PERSONNEL/LABOR

subcontractors and labor force

E VG S M U N/A

5. GENERAL

Yes No

REMARKS:

Email this questionnaire to: mmcook@fs.fed.us (Margaret M. Cook, USDA Forest Service, no later the closing date of the solicitation (proposed date 3-28-18).