Past_Performance_Questionnaire_Attch_H_4.25.18.pdf

APPENDIX B

PAST PERFORMANCE QUESTIONNAIRE

1. Information Provided in Response to RFP No.:12-94TZ-18-R-0002

2. Offeror:

PART I: Contract Information

3. Customer Organization:

4. Reference Name and Title: (individual completing this questionnaire)

5. Contract Number:

6. Contract Type:

7. Contract Value:

8. Project Manager:

9. Description of Work/Services:

10. Problems: (if problems encountered on this contract, explain corrective action taken)

This is a past performance questionnaire for the U.S. Forest Service to obtain past performance information on the contractor listed below. You should have received this questionnaire along with a request from the contractor listed below asking for your cooperation in completing this questionnaire. Information obtained in this questionnaire is for the sole purpose of evaluating the contractor’s past performance history to assist the U.S. Forest Service in determining the best value for award of a contract resulting from our solicitation. As an evaluator, your participation in this questionnaire is greatly appreciated.

INSTRUCTIONS

To complete this questionnaire, the contractor should:

1.Complete the CONTRACT INFORMATION on Page #.

2.Forward this questionnaire along with a Client Authorization Letter to the reviewer.

To complete this questionnaire, the evaluator should:

1.Review the CONTRACT INFORMATION section on Page #.

2.Complete the EVALUATION FACTORS section starting on Page 5 using the RATINGS on Pages 3-4 based on the Contractor Performance Rating System (CPARS).

Evaluate and assign a rating for Quality of Product or Service, Schedule, Cost Control, Business Relations, Management of Key Personnel, Utilization of Small business, and Customer Satisfaction. Include a narrative for each rating.

3.Return the questionnaire to the U.S. Forest Service by email to davidwatson2@fs.fed.us by May 23, 2018. NOTE: Any previous version of this form is acceptable for submittal.

QUESTIONS

If you have any questions about completing or submitting this questionnaire, please contact the Contracting Officer for this acquisition, David Watson at davidwatson2@fs.fed.us.

Part II: Performance Assessment (to be completed by reviewer)

CODE PERFORMANCE LEVEL

E EXCEPTIONAL - Performance meets contractual requirements and exceeds many to the reviewer’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD - Performance meets contractual requirements and exceeds some to the reviewer’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY - Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL - Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY- Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score. Performance in this area not applicable to effort assessed.

1. Quality of product or service: (please double click on check box to check and uncheck box)

E V S M U N

Comment:

2. Schedule: (please double click on check box to check and uncheck box)

E V S M U N

Comment:

3. Cost Control: (please double click on check box to check and uncheck box)

E V S M U N

Comment:

4. Management: (please double click on check box to check and uncheck box)

E V S M U N

Comment:

5. Utilization of Small Business: (please double click on check box to check and uncheck box)

E V S M U N

Comment:

6. Regulatory Compliance: (please double click on check box to check and uncheck box)

E V S M U N

Comment: