A04_Past_Performance_Questionnaire.docx

BUREAU OF LAND MANAGEMENT

MONTANA/DAKOTS’S REGION

PAST PERFORMANCE QUESTIONNAIRE

RFQ 140L3624Q0050 – Big Hole Class III Cultural Inventory-Butte MT

I. INTRODUCTION:

A Contractor your agency or company has conducted business with has referenced you for providing information dealing with past performance of a contract of similar nature as a current requirement of the Department of Interior’s Bureau of Land Management.

II. COMPLETION OF QUESTIONNAIRE:

· For assistance with this form, contact the Contracting Officer listed below.

· Handwritten responses will be accepted on if writing is legible. If you need more space than provided, please attach additional pages.

· Please include only recent (3 years or less) and relevant (cultural inventory/reporting) information.

· DO NOT return this questionnaire to the contractor for submission. It must be sent directly to the Contracting Officer listed below.

· IMPORTANT: Past performance questionnaire must be received prior to the closing date and time of the solicitation as listed below.

CONTRACTING OFFICER: Rebecca Undlin EMAIL: rundin@blm.gov

III. PROJECT SOLICITATON INFORMATION:

· Solicitation Number: 140L3624Q0050

· Closing Date/Time: 04/24/2024 5:00 pm Mountain Daylight Time

· Contract Type: Commercial

· NAICS Code: 541690

· Project Magnitude: $25K to $250K

IV. EXPLANATION OF CODES:

V VERY GOOD – Performance meets contractual requirements and EXCEEDS SOME requirements to the Government’s benefit. The contractual performance of 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 contractual performance of 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 contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions for the contractor’s proposed actions appear only marginally effective or were not fully implemented.

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

PLEASE COMPLETE THE FOLLOWING IDENTIFYING INFORMATION AND PAST PERFORMANCE ASSESSMENT:

V. CONTRACTOR IDENTIFICATION (Information for Contractor being rated)

VI. EVALUATOR INFORMATION:

(i.e., COR, CO, Owner, etc.)

VII. TERMINATION HISTORY:

Has this contract been partially or completely terminated for default, cause, or convenience?

YES _____ NO_____ DEFAULT_____ CAUSE_____ CONVENIENCE_____

VIII. ASSESSMENT ELEMENTS: Place an “X” in the appropriate space next to the letter for each item on the questionnaire. Narrative statements are vital. FOR EXCEPTIONAL AND VERY GOOD RATINGS, PLEASE EXPLAIN

PER EXPLANATION OF CODES ABOVE.

1. QUALITY OF SERVICE: (e.g., Did the contractor provide qualified personnel, necessary resources, and quality control? Did the contractor meet established guidelines and policies for safety and security? Did the completed work meet the required level of quality?)

E_____ V_____ S_____ M_____ U_____

2. SCHEDULE (e.g., Did the Contractor provide adequate staffing to meet workload requirements and was the work performed in a timely manner and in accordance with specifications of the requirement?)

E_____ V_____ S_____ M_____ U_____

3. BUSINESS RELATIONS: (e.g. Did contractor promote a strong working relationship with the Government/Company? Did the contractor adequately address and make efforts to resolve issues/problems concerning site employees? Did the contractor show initiative? Was the contractor courteous and responsive? Did the contractor interface effectively with your staff?)

E_____ V_____ S_____ M_____ U_____

4. MANAGEMENT OF KEY PERSONNEL (e.g., Was the contractor providing the site manager/leader/superintendent or key employees with the necessary resources, knowledge and support adequately perform the work? Did the contractor adequately address and make efforts to resolve issues and problems concerning the site manager/leader/superintendent or key employees? Was the contractor able to solve contract performance problems without extensive guidance from the government counterparts?)

E_____ V_____ S_____ M_____ U_____

5. Did the Contractor adhere to their technical and management approach? YES_____ NO_____

6. Please comment on any other contractor information you consider relevant to this evaluation:

7. Identify the Contractor’s overall strengths and weaknesses:

8. Given the choice, would you award to this contractor again? YES_____ NO_____