B08_Past_Performance_Questionnaire.docx

United States Department of the Interior

NATIONAL PARK SERVICE

NATIONAL CAPITAL REGION

1100 Ohio Drive SW Washington, D.C. 20242-0001

PAST PERFORMANCE AND EXPERIENCE QUESTIONAIRE

This form must be completed and signed by the Contractor Reference and sent directly to Contract Specialist/Contracting Officer at Robert_Murphy@nps.gov

I. CONTRACT IDENTIFICATION

Offeror’s Name: ____________________________________________________________

Contract Number: ____________________________________________________________

Total Contract Value: ____________________________________________________________ (Including Modifications)

Contract Type: ____________________________________________________________

Period of Performance: ____________________________________________________________

II. DESCRIPTION OF CONTRACT

Briefly describe all services provided under this contract.

III. RESPONDENT IDENTIFICATION

Name: ________________________________________________________________________

Agency/Company: ____________________________________________________________

Address: __________________________________________________________________

Telephone: __________________________________________________________________

Email ____________________________________________________________________

CONTRACTOR HISTORY

Please check the level of the Contractor’s overall performance in each of the factors listed below.

Check “N/A” if the factor does not apply to the contract being rated.

Quality and Accuracy of Deliverables

Quality of Services Performed

Timeliness of Services/Deliverables

Quality of Problem Solving

Quality of Project Management

Effectiveness of Communication with:

Government Personnel

Company Personnel

Supervision of Employees

Changes in Design

Compliance with:

Technical Requirements

Contractual Terms & Conditions

Adherence to:

Schedules

Projected Cost Estimates

Safety Policies & Procedures

Security Requirements

Standards of Conduct

Overall Performance

Customer Satisfaction

Were monetary reductions assessed? $_______________________

1. Would you award to this Contractor again?

2. Would you recommend another contact for further information?

* Please comment on all Fair and Poor ratings given, or on any other ratings as desired.

COMMENTS: __________________________________________________________________

SIGNATURE: _________________________________________________________________

DATE: _______________________________________________________________________

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