B08_Solicitation_-_Past_Performance_Questionnaire_attachement_6.doc

140P5324Q0031

Department of Interior

Past Performance Questionnaire (PPQ)

U.S. Department of the Interior, National Park Service is considering the company listed below in Section A for a project opportunity - Your comments would be appreciated regarding this company’s past performance.

Instructions:

1) The offeror is to complete only the information in Section A, then send the entire past performance questionnaire to project owner/evaluator for completion.

2) The project owner/evaluator (or reference) is to complete Section B, then send the entire past performance questionnaire back to the offeror to be provided with their complete proposal package, which will then be reviewed for evaluation.

3) The past performance questionnaire must be received by the contracting point of contact by the date and time specified in the solicitation (or any amendments). Please note that for electronic submissions, offerors should consider and account for potential delays in transmissions between when an electronic submission is submitted and when an electronic submission is received. Late past performance questionnaires will not be accepted.

4) One past performance questionnaire is to be used for each past performance project submitted. The offeror may submit between 2 past performance questionnaires for this solicitation. Past performance projects must have been completed within five years of the completion of performance of the evaluated contract or order.

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.

Section A

Project Title:

Location:

Description:

Section B

Evaluator

Position Held or Function in Relation to Project:

Ratings Overview

Rating: If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

Some material aspects of the contractor’s performance were less than satisfactory.

Questionnaire

Please select the appropriate rating and provide supporting information for the following questions.

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

FORMCHECKBOX

2. Overall corporate management, integrity, reasonableness, and cooperative conduct:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

3. Quality control:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

4. Ability to meet the performance schedule:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

5. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:

Yes

FORMCHECKBOX

No

6. Would you award another contract to the company being evaluated? If no, please explain:

Yes

No

No

8. Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings? If so, what were the results?

Yes

FORMCHECKBOX

No

9. Overall Rating

O

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

10. Comments

Evaluator Signature

Name

Date: