PAST_PERFORMANCE_QUESTIONNAIRE(sculpture)_Final_Draft.docx

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Attached to
Sculpture Conservation Federal contract opportunity
Solicitation number
17-005488
Issued by
Department of Health and Human Services National Institutes of Health

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PAST PERFORMANCE QUESTIONNAIRE

Soliciation # 17-005488

Please complete this Questionnaire and email to Christopher Lauver, Contract Specialist Email: christopher.lauver@nih.gov

We are currently in the process of preparing our proposal for Solicitation Number 17-005488. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance in therefore requested.

Please complete this Questionnaire and email to Contract Specialist, Christopher Lauver.

email: christopher.lauver@nih.gov

POC name:_____________________________________________________________________

POC phone number:_____________________________________________________________

POC e-mail address:_____________________________________________________________

If you will not be available for verification of this past performance evaluation, please indicate another POC for the Contracting Officer to contact.

Alternate POC name:_____________________________________________________________

Alernate POC phone number:______________________________________________________

Alternate POC e-mail address:_____________________________________________________

Thank you.

NAME OF OFFEROR:

Phone: Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number:___________________________________________

2. Contract Value:________________________________________________________

3. Period of Performance:__________________________________________________

4. Brief Description of Products/Services Provided: _________________________________________________________________________________________________________________________________________.

5. Name of Person Completing Questionnaire:_________________________________ Agency/Company: _____________________________________________________ Title:______________________________Phone:_____________________________

II. Evaluation. Please rate the Contractor using the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions:
The following definitions should be used in the assessment of Contractor performance.
Very Good
Performance EXCEEDS contractual requirements. The performance of the areas being assessed contained minor issues or concerns, for which the Contractor’s corrective actions were highly effective.
Satifactory
Performance MEETS contractual requirements. The performance of the areas being assessed contained minor issues or concerns, for which the Contractor’s corrective actions were effective.
Unsatisfactory
Performance DOES NOT MEET contractual requirements. The performance of the areas being assessed contained serious problems, issues or concerns; for which the Contractor’s corrective actions were ineffective.

Past Performance Evaluation

a. Performance

i. What is your assessment of the Contractor’s ability to meet your requirements in the following areas?

1. Evidence of conservation management efforts of similar large scale, outdoor sculptures.

Very Good
Satisfactory
Unsatisfactory
N/A

Performance (1)

2. Evidence in executing the cleaning and painting of similar large scale, outdoor sculptures.

Very Good
Satisfactory
Unsatisfactory
N/A

Performance (2)

b. Technical Approach

i. What is your assessment of the Contractor’s ability to meet your requirements in the following areas?

1. Paint/finish materials quality

Very Good
Satisfactory
Unsatisfactory
N/A

Technical (1)

2. Conservation activities

Very Good
Satisfactory
Unsatisfactory
N/A

Technical (2)

3. Project timeline adherence

Very Good
Satisfactory
Unsatisfactory
N/A

Technical (3)

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