Attachment E - Past Performance Questionnaire.docx
DOCX document 21 KB Posted
- Solicitation number
- 68HERC20R0012
About this file
This document contains a past performance questionnaire template and information about a related solicitation for labor services and warehouse operations. The past performance questionnaire is to be completed by references and submitted to the EPA Contracting Officer by December 23, 2019. It requests ratings on technical capability, project schedule, project management, and allows comments on exceptional or unsatisfactory performance.
The related solicitation is number 68HERC20R0012 for labor services and warehouse operations in the Washington D.C. metropolitan area. This requirement is set aside for women-owned small businesses. Services include labor and warehouse operations support. Responses are due by the date specified on the past performance questionnaire. The requirement is issued by the EPA Cincinnati Procurement Operations Division.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Offeror shall fill out top portion and send to Reference Organizations:
Name of Offeror Proposing on EPA Requirement: __________________________________________________
Brief Description of this Project and Relevance to the EPA Project: ___________________________________ __________________________________________________________________________________________________________________________________________________________________________________________ Name of Reference’s Organization: ______________________________________________________________ Contract Title: ________________________________________________________________________________ Contract Number: _________________________________ Contract Value: _____________________________
Type of Contract: _______________________________Period of Performance: __________________________
The ratings indicated below are to be supplied by the reference identified above and not the offeror.
| Performance Elements |
| Outstanding |
(See Question 4)
| Good |
| Acceptable |
| Marginal |
| Unsatisfactory |
(See Question 5)
1. Technical Capability
2. Project Schedule
3. Project Management
* Management, including subcontracts; reasonable/cooperative behavior; responsive to contract requirements; notification of problems; flexibility; proactive versus reactive.
4. Remarks on Exceptional Performance:
(Provide data supporting this observation. You may continue on a separate sheet, if needed.)
5. Remarks on Unsatisfactory Performance:
(Provide data supporting this observation. You may continue on a separate sheet, if needed.)
6. Other Comments:
(You may continue on a separate sheet if needed.)
7. Please identify any corporate affiliations with the offeror, if any.
8. Questionnaire completed by:
Name of Evaluator __________________________
Title __________________________
Date __________________________
Address __________________________
Phone number __________________________
Email: __________________________
Is the information presented at the top of form accurate: ________YES _________NO*
*If No, please describe the necessary corrections: _______________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please submit your completed Past Performance Questionnaire DIRECTLY to the U.S. EPA Contracting Officer, via email at vollman.jennifer@epa.gov no later than 1500 ET on December 23, 2019.
Past Performance Questionnaire
68HERC20R0012
File details come from the government source that posted it. Updated .