B08_ATTACHMENT_003_-_Past_Performance_Questionnaire.pdf
PDF 96 KB Posted
- Attached to
- ANJO-REPLACE ROOF SURFACE GARAGE Federal contract opportunity
- Solicitation number
- 140P5326R0014
About this file
This is a Past Performance Questionnaire template used to evaluate contractor performance during source selection for federal contract opportunities. The form is to be completed jointly by offerors and evaluating organization representatives and submitted to Marilia_Mateo@ios.doi.gov by May 19th, 2026.
The offeror section requires completion of contractor identification information including name, address, contract number, initiation and completion dates, contract value with options, contract type (Fixed Price, FPI, etc.), prime contractor name if applicable, and a description of contract requirements. The evaluating organization representative section requires the evaluator's name, position (Project Manager, CCR, or Other), organization, phone number, and the number of months the evaluator monitored contractor performance. The evaluation component consists of seven rating categories (A through G) to be scored using a five-point scale: Exceptional (EX), Very Good (VG), Satisfactory (S), Marginal (MG), Unsatisfactory (US), or Not Observed (N/O). The evaluation criteria assess Quality of Products and Services, Performance, Technical Requirements, Schedule, Cost Control, Customer Satisfaction, and Overall Assessment. The completed questionnaire is classified as source selection information under FAR 2.101 and 3.104 and must be protected accordingly.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140P5326R0014_Amd_0001.pdf | ||
| QUESTIONS_0001.docx | DOCX document | |
| A04_ATTACHMENT_001_-_Statement_of_Work.docx | DOCX document | |
| Sol_140P5326R0014.pdf | ||
| B03_ATTACHMENT_002_-_Wage_Rate_Determination.pdf | ||
| B04_ATTACHMENT_004_-_Construction_Contract_Administration.docx | DOCX document |
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this questionnaire and email to: Marilia_Mateo@ios.doi.gov
Desired Response Date: May 19th, 2026
When complete, the information in this form is SOURCE SELECTION INFORMATION {FAR 2.101 & 3.104 and shall be protected accordingly.
TO BE COMPLETED BY OFFEROR
1 CONTRACTOR NAME & ADDRESS
2. CONTRACT NO:
3. CONTRACT INITIATION DATE:
7. DESCRIPTION OF CONTRACT REQUIREMENTS:
4. COMPLETION DATE:
la: NAME OF PRIME CONTRACTOR
5. CONTRACT VALUE (with options):
6. TYPE OF CONTRACT (Fixed Price, FPI, etc.):
Pease add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/CCR/Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NO: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic (A-G) that best reflects your experience with this contractor.
EX= Exceptional S = Satisfactory US= Unsatisfactory
VG = Very Good MG = Marginal N/0 = Not Observed
A. Quality of Products and Services -Assess the contractor's conformance to contract requirements, specification, and standards of good workmanship (e.g. technical, professional, environmental, or safety and health standards). EX VG S MG US N/0
B. Performance -Assess the contractor's performance as the General Contractor or A/E (as appropriate) for the project. EX VG S MG US N/0
C. Technical Requirements -Assess the contractor's ability to fulfill the technical requirements of the contract. EX VG S MG US N/0
D. Schedule -Assess the timeliness of contractor against the schedule of activities.
EX VG S MG US N/0
E. Cost Control -Assess the contractor's ability to manage the contract budge and control costs.
EX VG S MG US N/0
F. Customer Satisfaction -Assess the contractor's responsiveness to customer concerns and user
"friendliness". EX VG S MG US N/0
G. Overall Assessment. EX VG s MG us N/0
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