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This document contains a past performance questionnaire related to a solicitation for base realignment and closure environmental construction and optimization services in the Midwest region. The questionnaire requests information about a contractor's past work on contracts such as contract number, period of performance, description of work, and role on the contract. It includes questions in several categories regarding program management and quality assurance, regulatory interaction and stakeholder coordination, and analysis and data management. Ratings of exceptional, very good, satisfactory, marginal, or unsatisfactory are requested for questions in each category, with explanations required for any marginal or unsatisfactory ratings. The signature of the contractor responding is also required.

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Text version

FA8903-20-R-0015

Midwest Region Past Performance Questionnaire

Past Performance Questionnaire Record Solicitation BECOS

Section 1: Contract Identification A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Specifics:

1. Contract or Task Order Number:

2. Contract Type (e.g. firm-fixed-price, CR, etc):

3. Period of Performance:

4. Geographic Location of work:

5. Contract Dollar Value: $

6. Description/scope of work performed:

7. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor

Section 2: Customer/Agency Identification

A. Customer/Agency name:

B. Primary Point of Contact:

1. Primary Name:

2. Primary Office:

3. Primary Address:

4. Primary Telephone:

C. Other suggested points of contact:

Section 3: Performance Areas:

In the tables below, indicate the rating that most accurately describes the contractor’s performance or situation by placing an “X” in the appropriate block to the right of each question. Provide supporting information in the remarks space provided. Attach additional pages if more space is needed. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this element, performance was not observed, or information was not available. Do not know.

1. Program Management and Quality Assurance The Contractor:

E
VG
S
M
U
N/A

A. Provided documents, technical plans, and reports that were accurate, timely, complete, and demonstrated quality. (did not require excessive revision)

B. Performed site work in compliance with required and applicable regulations. (such as, health and safety, ARARs, environmental, OSHA, state, federal, professional certifications and registrations)

C. Performed record of decision, decision documents, feasibility studies and / or conceptual site models preparation and amendments timely, as required, and IAW regulation.

D. Implemented RCRA processes and / or CERCLA processes IAW regulation and protective of Human Health and the Environment (an "exceptional or very good" represents completion of combined actions / interrelated pieces of the entire the RCRA and / or CERCLA process).

E. Worked with state regulatory processes IAW regulation and protective of Human Health and the Environment.

Narrative/Remarks:

2. Regulatory Interaction and Stakeholder Coordination

E
VG
S
M
U
N/A

A. Worked proactively and collaboratively with the Government and engaged regulatory agencies well in order to achieve goals such as project and / or performance objectives, reduced Life Cycle Costs, modification of remedies and decision documents.

B. Implemented and / or facilitated Community Involvement, addressed challenging stakeholders and / or collaborated with community stakeholders such as public events, meetings and during work related to Site Closeout, Restoration Advisory Boards, and / or additional outreach.

C. Transitioned work well, providing all the required documents (such as, GIS, mapping, records, and plans) to coordinate contract closeout and assist the incoming contractor successfully without major issues.

D. Performed an effort that required work on multiple remediation disciplines with more than (5) five sites on installations or former installations. (able to coordinate work on multiple sites and areas well)

E. Managed environmental restoration activities on property with multiple owners / stakeholders. Such as local redevelopment authorities, private entities, federal agencies and municipalities.

3. Analysis and Data Management

E
VG
S
M
U
N/A

A. Provided reports (such as, work plans and conceptual site models) that demonstrate knowledge and technical acumen in Environmental Remediation and / or Restoration.

B. Applied an innovative approach in order to accelerate site closeout at a site.

C. Exhibited technical acumen in assessing, analyzing, and validating data. (quality data analysis and integrity in sampling data)

D. Designed, installed, operated, maintained, and / or optimized remediation systems, such as, a pump and treat system in a manner that ensures maintenance of the selected remedy.

E. Consistently monitored the current remedy progress and / or tracked site progress issues, communicated progress / metrics, and reported on achievement of cleanup goals and performance objectives. (organized and clear metrics / reporting)

4. Were there any adverse performance issues/problems? If so, how were they resolved? (Please reference questions above by topic area and letter.)

Reports/LettersY/N
Contract Discrepancy Report

Cure Notice

Show Cause Notice

Suspension of Payment

Termination for Convenience/Default

Denial of Claim

Other

Remarks:

Response by:

___________________________________________
Print NameTitle
___________________________________________
SignatureDate

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