010_Customer_Ratings_Form.pdf

CUSTOMER RATING & PAST PERFORMANCE QUESTIONNAIRE

Solicitation No. 140P3025R0004

Please complete and send this questionnaire via email to dianna_durbin@nps.gov

We are currently preparing our proposal for the National Park Service, Contracting Operations National, Solicitation Number: 140P3025R0004 for Crosswalk Line Striping within multiple areas of the National Capital Region. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency or company under the previous or ongoing contract listed below. Your input on our performance is therefore requested.

This Questionnaire is due to Dianna Durbin no later than 04:00 PM EDT on MAY 30, 2025. The Questionnaire must be submitted directly to the Contracting Officer from a corporate or government email account.

If you are or will be unavailable for verification (if necessary) of this past performance evaluation, please indicate another point of contact (POC) for the Contracting Officer to contact.

Reference Provided For:

(Name of Offeror)

Please provide information for the primary individual(s) completing this survey

Name:

Title:

Company or Agency:

Phone No:

Mailing Address:

Email Address:

Contract or Project Referenced Contract or Project No.:

Title or Description

Contract Value:

Period of Performance:

RATING DESCRIPTIONS: Use the following descriptions as guidance in providing ratings.

RATING DEFINITION

Exceptional (1) Indicates the contractor’s performance record within the area of evaluation Exceeded that required by the contract.

Good (2) Indicates the contractor’s performance record within the area of evaluation Met All contractual requirements.

Satisfactory (3) Indicates the contractor’s performance record within the area of evaluation Met Essentially All contractual requirements.

Marginal (4) Indicates the contractor’s performance record within the area of evaluation Met Some of the contractual requirements. However, changes to the contractor’s existing processes may be necessary in order to achieve contract requirements.

Unsatisfactory (5) Indicates the contractor’s performance record within the area of evaluation Failed to Meet the minimum Government requirements.

Unknown or Not Applicable (6)

The question does not apply. No performance record identifiable within the area of evaluation.

SOURCE SELECTION SENSITIVE WHEN COMPLETED

(1) How responsive was the contractor’s quality program in identifying, correcting, and preventing initial and recurring contract discrepancies?

1 2 3 4 5 6

REMARKS:

(2) How complete were the contractor’s quality procedures and how well do employees follow them? 1 2 3 4 5 6

REMARKS:

(3) Rate timeliness in meeting requirements and adhering to contract schedules (delivery/performance). 1 2 3 4 5 6

REMARKS:

(4) Did the contractor provide adequate, competent and qualified, management, key personnel and technical personnel capable of meeting contract requirements throughout the performance period of the contract?

1 2 3 4 5 6

REMARKS:

(5) How flexible, cooperative, and reasonable was the contractor in meeting mission

Requirements, particularly when faced with short-notice mission changes?

1 2 3 4 5 6

REMARKS:

(6) How effective was the contractor’s safety program to ensure compliance with federal, state and local regulations? Did the contractor implement and follow their safety plan? Did they run a “safe” jobsite?

1 2 3 4 5 6

REMARKS:

(7) Applicable to Federal Contracts – How well did the contractor comply with applicable Federal Laws and Regulations such as Service Contract Act – timely payrolls and compliance; Drug-Free Workplace; Executive Order 13101?

1 2 3 4 5 6

REMARKS:

(8) How innovative was the contractor in performing the technical aspects of this contract and resolving problems? How well did the contractor respond to and act on customer feedback? (Customer Satisfaction)

1 2 3 4 5 6

REMARKS:

(9) How would you rate the Contractor’s overall performance?

1 2 3 4 5 6

REMARKS:

(10) Please Provide Any Additional Information You Feel Is Important Not Covered Elsewhere:

Thank you for your remarks. Be sure to return this form to the Contracting Agency and not to the Contractor referenced with the Reference ID Form you were provided.

Signature:

Date Completed: