Attachment_5_-_Ctr-Past-Perform-Form_0001.docx

Attachment 5

PART I - PAST PERFORMANCE EVALUATION

Offerors are required to send the attached ‘Past Performance Evaluation Questionnaire’ (Part II of this form) to a minimum of three Federal Government clients for whom it has performed similar services in the past five years. If the offeror has no past performance working with Federal Government agencies, then the questionnaire shall be sent to State/Local Government agencies. If the offeror has no past performance working with State/Local Government agencies, then the questionnaire shall be sent to other private concerns. The offeror shall provide the names, addresses, and telephone numbers of the References asked to participate in the evaluation. The offeror shall complete this form (Part I) and include it with their Non-Cost/Price Factors (Proposal, Volume 1).

NOTICE TO CONTRACTOR

Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise.

This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services.

The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.

Contractor Being Evaluated:

Address:

City/State/Zip:

Phone Number:

If Subcontractor, Prime Contractor is:

REFERENCE LIST

REFERENCE #1

Company Name:

Name / Title:

City/State/Zip

Email Address:

REFERENCE #2

Company Name:

REFERENCE #3

Company Name:

If needed:

REFERENCE #4

Company Name:

REFERENCE #5

Company Name:

PART II - PAST PERFORMANCE EVALUATION QUESTIONNAIRE

I. Background:

The purpose of this questionnaire is to obtain past performance information relative to contracts that have previously been completed by, or are currently being performed by, the contractor identified above. The company is a potential source for performing a Firm Fixed Price contract. NOTE: Your assistance in evaluating the contractor’s past performance is appreciated. The goal of NPS is to award a contract to the contractor whose offer represents the ‘Best Value’ to the Government. Your past performance evaluation is a consideration in determining ‘Best Value.’

II. Instructions to Evaluator:

Please complete the questionnaire based on the following guidance:

A. Handwritten responses are sufficient.

B. Indicate, based on the descriptions/definitions below (reference Section III, Rating of Contractors), the contractor's performance on the identified program in the assessment area. Assessments should reflect only contractor liable performance. Please provide comments for all questions in which a Poor, Marginal, or Satisfactory rating is given and as appropriate for all other answers. Space for comments is provided. If additional space is needed, additional pages may be attached to the end of the questionnaire (please reference the respective question).

C. Evaluators are urged to supplement personal knowledge of the contractor's performance with the judgment of others in their organization. In addition to completing the attached questionnaire for the program, NPS is requesting comments on other similar programs for which your office has had contact with the contractor.

C. PLEASE EMAIL YOUR COMPLETED QUESTIONNAIRE TO:

Stacy_Vallie@nps.gov

III. Rating of Contractors:

1. Did the Contractor provide a Safety Plan? YES ☐ NO ☐

2. Overall performance in providing and performing he contract requirements in accordance with the scope of work including adherence to safety control measures and quality controls:

CONFIDENCE LEVEL:

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

COMMENTS:

3. Did the contractor provide submittals in a timely manner? YES ☐ NO ☐

4. How would you rate the contractor’s performance pertaining to the contract submittal process?

CONFIDENCE LEVEL:

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

5. How well did the contractor’s on-site superintendent control overall quality?

CONFIDENCE LEVEL:

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

6. How well did the contractor manage any customer complaints in regard to timeliness of response, the quality of management, quality of the accountability of complaints, and quality of reporting complaints?

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

7. How well did the contractor adhere to the contract schedule?

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

8. How well did the contractor manage subcontractors?

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

9. How well did the contractor comply with the contract terms and conditions?

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

10. Were any cure or delinquency notices issued? If so, please explain.

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

11. Were there any modifications? If so, please provide a brief description.

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

12. Overall evaluation rating of the contractor:

Substantial ☐ Satisfactory ☐ Limited ☐ No ☐ Neutral ☐

Check the most applicable answer:

Knowing what I know about this contractor, ☐ I would enter into another contract with this contractor.

☐ I might enter into another contract with this contractor.

☐ I would not enter into another contract with this contractor.

IV. Program Identification To Be Completed by Evaluator (This information will assist in the analysis of the data and will be kept confidential.)

Name of Evaluator:

Position/Title:

Email:

Date Questionnaire Completed:

Contract Number:

Estimated Contract Amount:

Period of Performance:

Description of Services Received:

Contract Type:

Solicitation #140P1423R0009 Lake Trout Gill- and Trap-netting on Yellowstone Lake