Attachment D - Past Performance Questionnaire.docx
DOCX document 33 KB Posted
- Solicitation number
- 2031ZA26R00023
About this file
This is a Past Performance Questionnaire template designed for offerors responding to the Wastewater Pretreatment Plant Operation and Maintenance Services solicitation. The document serves as an evaluation tool to assess contractor qualifications and experience relevant to managing the Bureau of Engraving and Printing's industrial wastewater treatment facility in Washington, DC.
The questionnaire is structured to gather detailed information about the contractor's past performance on similar projects, including experience with wastewater pretreatment operations, maintenance of industrial treatment systems, 24/7 operational support capabilities, and technical expertise. Offerors are expected to provide documented examples of relevant projects, demonstrating proficiency with systems comparable to BEP's four-system configuration (Wiping Solution Wastewater Pretreatment Plant, Plating Wastewater Pretreatment Plant, Grease Trap Wastewater Pretreatment Plant, and Wiping Solution Recycling Plant). The template likely requires information on project scope, duration, client references, performance metrics, and the contractor's role in similar operations and maintenance contracts. This questionnaire is a critical component of the evaluation criteria and enables the government to assess the offeror's ability to meet the demanding 24/7 operational requirements and technical support needs of BEP's facility.
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ATTACHMENT C: PAST PERFORMANCE QUESTIONNAIRE
Instructions:
· The Bureau of Engraving and Printing (BEP) requests recent past performance. Recent is defined as five (5) years from the date of Request for Quotation (RFQ) issuance.
· Offeror shall send the questionnaire to at least two (2) Assessors (personnel or organization) for which services were provided. Services must be relevant to BEP’s requirement. Relevant is defined as similar in size, scope, and complexity to the BEP’s requirement identified in the Performance Work Statement.
· Offeror shall complete Section II prior to submitting the questionnaire to Assessor(s).
· The Assessor(s) shall validate/confirm Section II information and complete Sections III and V.
· The Assessor(s), NOT THE OFFEROR, shall email the completed questionnaire to the contracting office point of contact no later than the date and time indicated below.
Message to the Assessor: Your assistance is requested by the BEP to assist with establishing the performance history for the Contractor named below. Please validate/confirm Section II information, complete Sections III and V, and sign the questionnaire. Completed questionnaire shall be emailed to marico.sellers@treasury.gov no later than 12:00 PM Eastern, on Tuesday, 15 September 2026.
I. Solicitation Data (for the proposed effort)
| Solicitation Number |
| 2031ZA26R00023 |
| Project/Requirement |
| Wastewater Pretreatment Plant in Washington, DC |
II. Current or Historical Contract Information Assessor: The performance data submitted by the Offeror is |_| correct or |_| incorrect.
Name of Company Reference is for: _____________________________________________________
CONTRACTOR NAME & ADDRESS:
Contract No
Type of Contract
| Initial |
| Final |
Contract Value
Period of Performance/Delivery Schedule
Project/Requirement Description
Please select from the following as it applies to this contract:
| Contracting Role |
| |_| PRIME |
| |_| SUBCONTRACTOR |
| Termination History |
| |_| Convenience |
| |_| Default |
| |_| N/A |
III. Assessor Information
Assessor Name
Title
Phone Number/Email Address
Identify your role in the contract award or administration and the period of your involvement.
| Role |
| Period of Involvement |
Procuring Contracting Officer (PCO)
Administrative Contracting Officer (ACO)
Contract Specialist
Contracting Officer’s Representative (COR)
Technical Project Lead/Project Manager
Quality Assurance Specialist
Defense Contract Audit Agency (DCAA) Auditor
Other:
IV. Evaluation Definitions
The following definitions should be used in your assessment of Contractor performance.
| EXCEPTIONAL |
| Contractor’s performance significantly exceeded most or all contract requirements. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective. |
| VERY GOOD |
| Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective. |
| SATISFACTORY |
| 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. |
| MARGINAL |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the Contractor has not yet identified corrective actions. The Contractor’s proposed actions appear only marginally effective or were not fully implemented. |
| UNSATISFACTORY |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problems(s) for which the Contractor’s corrective actions appear or were ineffective. |
| NOT APPLICABLE (N/A) |
| Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment. |
V. Performance Evaluation
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unacceptable |
| N/A |
CUSTOMER SATISFACTION
The referenced contractor was responsive to the customer’s needs.
The contractor’s personnel were qualified to meet the requirements.
SCHEDULE PERFORMANCE
The contractor’s ability to ensure, to the extent of its responsibility, that all tasks were completed within the requested time frame.
Time required for vendor to respond to emergencies and service requests.
Timeliness in Meeting Milestones and deliverables (if applicable)
MANAGEMENT PERFORMANCE/PROGRAM MANAGEMENT
The contractor had a clear understanding of the tasks detailed in the Statement of Work/Performance Work Statement
The contractor’s ability to complete tasks correctly the first time.
The contractor’s ability to resolve problems/issues.
Was the contractor’s management effective in controlling cost, schedule and performance requirements?
QUALITY
What is your OVERALL assessment of the quality of the contractor’s performance? Were your specifications and expectations met by the contractor?
Quality of the finished product; please note any specific issues.
Conformance to Contract Requirements
Corrected deficiencies in a timely manner
Standards of Good Workmanship
COST
The contractor’s ability to accurately estimate cost.
COST/PRICE ESTIMATES—(ability to meet proposed costs and whether actual costs/rates realized reflect negotiated costs/rates)
INVOICING—accuracy and timeliness of submission
Based on this Contractor’s overall performance, would you award this Contractor another contract?
Yes________ No___________ If no, please explain:
General Comments:
| _________________________________ | ____________________ | |
| Assessor’s Signature | Date |
1 | Page 2031ZA26Q00131
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