B08_Attachment_15_Past_Perf_Questionnaire_UPDATED_0002.docx
DOCX document 34 KB Posted
- Solicitation number
- 140L0625R0002
About this file
This document is a Past Performance Questionnaire for a federal contract (Solicitation Number 140L0625R0002) related to the Shoshone Wildland Fire Operations and Field Office project, issued by the Department of the Interior Bureau of Land Management. The questionnaire is designed to evaluate a contractor's performance across multiple areas including quality, schedule and time management, pricing and payments, management, and regulatory compliance, using a rating scale from Exceptional (EX) to Unsatisfactory (U).
The contract appears to be a Firm Fixed Price or Time & Materials type, with an unspecified total awarded contract price. The document provides a structured template for a reference to assess the contractor's performance, requesting detailed ratings and comments on various project execution aspects. The questionnaire is to be returned by 08 July 2025 to Kassandra Hicks, a Contract Specialist, with the purpose of documenting and evaluating the contractor's capabilities for potential future similar contracts within the Department of the Interior.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
140L0625R0002 – GAOA SHOSHONE FIELD OFFICE REPLACEMENT
A. CONTRACTOR INFORMATION
| Company Name |
| Company |
| Street Address |
| Address |
| City |
| City |
| State |
| State |
| Zip Code |
| XXXXX |
| DUNS Number |
| XXXXXXX |
| Point of Contact |
| Name, Email, Phone |
B. CONTRACT INFORMATION
| Project Title |
| Title |
| Contract Number |
| XXXXXXXXXX |
| Contract Type |
| Firm Fixed Price / Time & Materials / Cost Reimbursable / Other |
| Awarded Contract Price |
| $X,XXX,XXX |
| Current / Final Price |
| $X,XXX,XXX |
| Contract Award Date |
| XX/XX/XXXX |
| Contract Completion Date |
| XX/XX/XXXX |
| Project Location |
| Street address, City, State |
| Client / Owner |
| Company |
| Brief description of the contract & work effort: |
| Scope of work description |
C. REFERENCE:
Name
Position / Title
Organization
Phone Number
Email Address
Signature
Date
D. EVALUATION
| Rating |
| Definition |
| Exceptional (EX) |
| Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| Very Good (VG) |
| Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory (S) |
| Performance met contractual requirements. The element being assessed contained some minor problems for which corrective actions taken by the contractor were satisfactory. |
| Marginal (M) |
| Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective action. |
| Unsatisfactory (U) |
| Performance did not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions were ineffective. |
Not Applicable (NA)
The element does not pertain to the subject project as a result of specific contract and/or project requirements.
| Evaluation Area |
| Rating |
Quality
Quality of workmanship (including subcontractors)?
Quality of and adherence to quality control plan?
Quality of informational and technical submittals?
Overall Quality Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Schedule & Time Management
Met project schedule milestones and/or deadlines?
Responded to owner requests in a timely manner?
Informational and technical submittals submitted timely?
Promptly addressed scheduling issues?
Overall Schedule & Time Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Pricing and Payments
Minimized additional costs when addressing differing & unforeseen site conditions?
Provided fair and reasonable pricing for contract modifications?
Submitted accurate and complete invoices?
Promptly paid subcontractors and suppliers?
Overall Pricing and Payment Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Management
General oversight by project manager and superintendent?
Coordination with and control of subcontractors?
Avoidance of accidents & safety violations?
Addressed location factors (especially remote locations)?
Maintained good working relationship with owner representatives?
Demonstrated flexibility, innovativeness and cooperation in resolving potential problems?
Overall Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Regulatory Compliance
Met building and life safety codes?
Met regulatory and contractual labor standards?
Overall Regulatory Compliance Rating
Overall Recommendation:
Given what I know today about the contractor's ability to perform in accordance with the contract’s most significant requirements, I would recommend them for similar contracts:
Overall Comments:
E. RETURN:
| Return by |
| 08 July 2025 |
| Name |
| Kassandra Hicks |
| Title |
| Contract Specialist |
| Organization |
| Department of the Interior |
| khicks@blm.gov |
File details come from the government source that posted it. Updated .