Past_Performance_Questionnaire_0001.docx

SOLICITATION 140P8621R0028

ATTACHMENT 6

PAST PERFORMANCE QUESTIONNAIRE

HAZMAT REMEDIATION & INTERIOR DEMOLITION OF BLDG 112

(Name of Firm Submitting a Proposal), an offeror on the subject solicitation, requests your participation in responding to this questionnaire:

The purpose of this questionnaire is to obtain information regarding the quality and extent of the above-named contractor's past performance relative to a contract, completed or in progress, for your company/agency. This contractor has submitted a proposal for the following work:

Abatement of hazardous materials and interior demolition at National Park Service (NPS) Building 112, the Bay Grounds shop, located within the Fort Mason Historic District of the Golden Gate National Recreation Area in San Francisco, California.

Handwritten responses are sufficient. We request that the individual(s) responsible for the administration oversight of the project (e.g., Project Manager, Contracting Officer's Representative (COR), etc.) respond to this questionnaire.

PLEASE COMPLETE AND RETURN FORM PROMPTLY. Upon completion of the enclosed questionnaire, please email to Lei_Yang@nps.gov.

Enclosure: PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE QUESTIONAIRRE

Prospective Contractor:

Current National Park Service Solicitation: 140P8621R0028

Your Company Name

Contract Number:

Total Amount:

Dates of Contract:

Description of Work Performed:

Location of Work Performed

Your Company Point of Contact Name:

Your Company's Point of Contact Telephone #:

Your Company's Point of Contact Email Address:

Satisfactory is defined as: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Was the Contractor's work satisfactory?

Contractor is or recently has been seriously deficient in contract performance?

If yes, what are the circumstance?

If yes, were the circumstance beyond the contractor's control?

If yes, has the contractor taken appropriate corrective action?

Contractor is/has applying/applied sufficient tenacity and perseverance to perform acceptably?

If no, what are the circumstance?

If no, were the circumstance beyond the contractor's control?

If no, has the contractor taken appropriate corrective action?

Contractor has satisfactorily met quality requirements?

Contractor is performing work with subcontractors?

If yes, how would you describe the contractor's relationship with their subcontractor(s)?

Does/Did the contract require a subcontracting plan pursuant to Subpart 19.7, The Small Business Subcontracting Program?

If yes, how did the contractor perform against the subcontracting plan?

Would you categorize the contractors integrity and business ethics as satisfactory?

If no, why not?