A-4_Past Perf Questionnaire.pdf
PDF 207 KB Posted
- Solicitation number
- 12443925Q0027
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a Past and Present Performance Questionnaire for Custodial Janitorial Services, solicitation number 12444825Q0027. The form is designed to evaluate a contractor's performance across multiple dimensions, including management capabilities, problem-solving skills, quality control, and overall contract execution. The questionnaire uses a 1-5 rating scale to assess various performance criteria such as technical abilities, quality control procedures, problem identification, cooperation with government personnel, and initiative in resolving issues.
The document requires completion by the offeror's customer and is to be returned no later than 12 October 2025 via email to Amelia Dávila-Garcia at amelia.davila-garcia@usda.gov. The form includes sections for general contractor information, detailed performance ratings, and allows for additional remarks. Key evaluation areas include the contractor's ability to provide experienced managers, participate in problem-solving, implement quality control, correct deficiencies, and cooperate with government personnel. The questionnaire also includes yes/no questions about whether the contractor received any cure notices, is rated in the Contractor Performance Assessment Report System (CPARS), and whether the respondent would award another contract to the contractor.
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12444825Q0027 Custodial Janitorial Services
Attachment A-4
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE
When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and 3.104
A. GENERAL INFORMATION: This area is to be filled by the Offeror.
OFFEROR/CONTRACTOR’S NAME: _____________________________________________
Telephone Number: _________________________
Address: ____________________________________________________________
Project Title or Brief Description of Work: _____________________________________________
Contract Number Provided by Offeror: ________________________
Dollar Amount: $________________________
Contract Period or Dates of Performance Provided by Offeror: ___________________________
Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.
B. RESPONDENT INFORMATION: This area and the next page (questionnaire) is to be filled by the Offeror’s Customer.
Please correct any information above known to be inaccurate:
Name of Respondent: __________________________ _____________________________
Title: _____________________________________
Telephone Number: _______________________________
Email Address: _______________________________
NOTE TO RESPONDENT: Please return no later than 12 October 2025 via email to Amelia Dávila-Garcia at amelia.davila-garcia@usda.gov.
mailto:amelia.davila-garcia@usda.gov
12444825Q0027 Custodial Janitorial Services
Attachment A-4
A. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. Alternatively, select N/A where appropriate.
PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.
1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
1 2 3 4 5 N/A
2. Home office participated in solving significant local problems. 1 2 3 4 5 N/A
3. Provided effective quality control and/or inspection procedures to meet contract requirements.
1 2 3 4 5 N/A
4. Corrected deficiencies in timely manner and pursuant to their quality control procedures.
1 2 3 4 5 N/A
5. Identified problems as they occurred. 1 2 3 4 5 N/A
6. Suggested alternative approaches to problems. 1 2 3 4 5 N/A
7. Displayed initiative to solve problems. 1 2 3 4 5 N/A
8. Cooperated with Government personnel after award. 1 2 3 4 5 N/A
9. How would you rate the contractor's overall performance? 1 2 3 4 5 N/A
10. Was the contractor ever issued a cure or show cause notice under the referenced contract?
If yes, explain outcome in “remarks.”
YES/NO
11. Is the contractor rated in Contractor Performance Assessment Report System (CPARS)? YES/NO
12. Would you award another contract to this contractor? If not, explain in “remarks.” YES/NO
CONTRACTOR’S NAME: CONTRACT NUMBER:
Remarks: ________________________________________________________________________________
NOTE TO RESPONDENT: Please return no later than 12 October 2025 via email to Amelia Dávila-Garcia at amelia.davila-garcia@usda.gov.
1 2 3 4 5 N/A UNSATISFACTORY MARGINAL SATISFACTORY VERY GOOD EXCEPTIONAL NEUTRAL or N/A
Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.
Performance did not meet some contractual requirements.
There were problems, some of a serious nature, for which corrective action was only marginally effective.
Performance met contractual requirements.
There were some minor problems and corrective actions taken by the contractor were satisfactory.
Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.
Performance met all contract requirements and exceeded many to the government’s benefit.
Problems, if any, were negligible and were resolved in a timely, highly effective manner.
No record of past performance, the record is inconclusive, or rated area is not applicable.
mailto:amelia.davila-garcia@usda.gov
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