1305M326Q0401_Attachment_4_-_Past-Performance-Questionnaire.docx
DOCX document 4 MB Posted
- Attached to
- Milford (CT) Lab Sea Water Pump House Renovation
- Solicitation number
- 1305M326Q0401
About this file
This is a Past Performance Questionnaire template used by the National Oceanic and Atmospheric Administration (NOAA) to evaluate contractor performance on previous relevant contracts. The template is designed to be completed collaboratively, with offerors and major subcontractors providing initial contract information in Sections I and II, which is then validated and supplemented by government assessors who had direct experience administering the contract. Assessors complete Sections III and IV, documenting their role and involvement period, and providing an overall performance rating based on contract compliance, quality and timeliness of delivery, cost management, communications, and customer satisfaction.
The questionnaire is structured to support source selection for solicitation 1305M326Q0401 for Milford Laboratory Sea Water Pump House Renovation. Offerors must submit copies of Sections I and II of all completed questionnaires with their proposals by the solicitation closing date, while assessors submit completed questionnaires directly to NOAA at the designated email address. Performance ratings range from Exceptional to Unsatisfactory, with detailed criteria for each level, and assessors may also provide additional comments or notes. This template does not specify required products, services, response dates, or pricing terms, as it functions solely as an evaluation instrument for past performance history rather than a statement of work or solicitation requirements document.
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Text version
1305M326Q0301
ATTACHMENT #4
Past Performance Questionnaire Template
Instructions:
· Sections I and II to be completed by the Offeror/Major Subcontractor and provided to the assessor (Government personnel that had experience with the Offeror/Major Subcontractor on a previous relevant contract). The assessor, in turn, to verify Sections I through III, complete the questionnaire, and submit to the Contracting Office. The Offeror should also submit with its proposal (by the closing date of the Solicitation) copies of Sections I and II of all questionnaires as provided to assessors.
· Section II to be validated by the assessor. If any information is incorrect herein, please annotate and provide the correct information accordingly.
· Sections III through IV to be completed in their entirety by the assessor.
Message to the assessor: Your feedback is requested by NOAA to assist with establishing the performance history for the Contractor named below. In efforts to expedite receipt of the requested information, the Contracting Office respectfully requests that you please e-mail the completed questionnaire(s) to: name@noaa.gov.
I. Solicitation Data (for the proposed effort)
| Solicitation Number |
| 1305M326Q0301 |
| Project/Requirement |
| Santa Cruz Laboratory Cooling Tower & Chiller Maintenance |
| Customer/Agency |
| NOAA (AGO) |
| Project/Requirement Description |
| Santa Cruz Laboratory Cooling Tower & Chiller Maintenance & Servicing. Base + 4 Option Years. |
II. Current or Historical Contract Information
Assessor: The performance data submitted by the Offeror is ☐ correct or ☐ incorrect.
CONTRACTOR NAME & ADDRESS:
Contract No
Type of Contract
| Initial |
| Final |
Contract Value
Period of Performance/Delivery Schedule
Project/Requirement Description
Please select from the following as it applies to this contract:
| Contracting Role |
| ☐ PRIME |
| ☐ SUBCONTRACTOR |
| Termination History |
| ☐ Convenience |
| ☐ Default |
| ☐ N/A |
III. Assessor Information
Assessor Name
Title
Phone Number/Email Address
Identify your role in the contract award or administration and the period of your involvement.
| ✔ |
| Role |
| Period of Involvement |
Procuring Contracting Officer (PCO)
Administrative Contracting Officer (ACO)
Contract Specialist
Contracting Officer’s Representative (COR)
Technical Project Lead/Project Officer
Quality Assurance Specialist
Defense Contract Audit Agency (DCAA) Auditor
Other:
IV. Overall Performance Rating
Please provide the overall performance rating based on performance of contract requirements, quality and timeliness of delivery of goods, services and/or construction, cost management, communications between contracting parties, proactive management and/or customer satisfaction.
| EXCEPTIONAL |
| Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns. |
| VERY GOOD |
| Performance EXCEEDS SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective. |
| SATISFACTORY |
| Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective. |
| MARGINAL |
| Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective. |
| UNSATISFACTORY |
| Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective. |
| NOT APPLICABLE (N/A) |
| Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment. |
Additional comments/notes:
Source Selection Information – See FAR 2.101 and FAR 3.104 For Official Use Only
File details come from the government source that posted it. Updated .