ATTACHMENT 4 - PAST PERFORM QUESTNR 07FEB2022.doc

USDA NRCS - MS Office

Solicitation 12FPC422Q0005, State of Mississippi Three (3) Blanket Purchase Agreements (BPAs) for Legal, Title and Real Estate Services

[PLEASE ENTER FIRM NAME]

ATTACHMENT # 4

RELEVANT PAST PERFORMANCE QUESTIONNAIRE

Note: To be completed by your references and returned by your references to the Contract Specialist by the date specified. Failure to do so may result in rejection of your quote.

Your organization has been identified for participation in the past performance evaluation on a current solicitation at the Farm Production and Conservation Business Center (FPAC-BC). This survey will be used to evaluate the past performance for the Contractor.

Your candid response to the questions is important to our evaluation effort and may affect the award outcome. Please indicate "N/A" in any area which is not applicable to work performed on your contracting action. The names of individuals supplying past performance information will remain confidential.

Please take a moment to complete the enclosed survey and email the completed survey to the contact listed below by 14:00 PM ET on February 11, 2022. A representative of FPAC-BC may contact you to arrange a time for a phone interview to review the survey. If you have any questions regarding this survey please contact:

Ms. Regi Troullier

Email: Regi.Troullier@usda.gov The following information is being requested:

Evaluators name, position, organization, and role on the contract:

Evaluator’s phone # and email address:

Number of month’s Contractor performance was monitored by evaluator:

Contract number:

Contractor’s name, operating unit and address:

Type of contract:

Program Name:

Contract Initiation date:

Contract completion date (including extensions):

Years Remaining:

Describe any schedule changes and reasons for schedule changes (if any):

Award Amount: $ Current Contract $ Value (including exercised options and extensions): $ Projected Final Contract $ Value (including exercised options and extensions): $ Reason why Award Amount and Current or Projected Final Contract $ Value differs (if they differ):

Description of the work performed (include the size, scope, and complexity of the project):

1. Please rate each item listed below (circling is preferable; Use “1” through “5” with “5” being outstanding and “1” being unsatisfactory; N/O means (Not Observed)) and Provide Comments to identify Specific Strengths/Weaknesses in each area

A. Project Management

Comments (List specific strengths and weaknesses):

B. Timeliness of Performance - Assess the timeliness of the Contractor against the completion of the contract, contracts, milestones, delivery schedules, administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Comments (List specific strengths and weaknesses):

C. Cost Control – Assess the Contractor’s effectiveness in forecasting, managing, and controlling contract costs (*Do not rate this item for Firm Fixed Priced contracts).

Comments (List specific strengths and weaknesses):

D. Business Relations – Assess the integration and coordination of relationships needed to execute the contract

Comments (List specific strengths and weaknesses):

2. Overall Assessment: (please circle)

NOT OBSERVED

Comments (List any major strengths and major weaknesses):

3. Has any adverse past performance information identified above been shared with the Contractor?

( ) Yes: Written or Oral?

Date__________

( ) No: FPAC may provide the Contractor with an opportunity to respond to any adverse past performance information.

( ) N/A

4. Would you select this Contractor again?

( ) Yes.

( ) No.