A13 - Past Performance Questionnaire.docx
DOCX document 26 KB Posted
- Attached to
- GAOA Buck Hall Recreation Phase 1 Renovation
- Solicitation number
- 12445226R0008
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Past Performance Questionnaire template for the Buck Hall Recreation Site Renovation project. The document is designed to be completed by offerors in Section A and then distributed to their references for completion of Section B. References must submit completed questionnaires directly to Penny Zortman (penny.zortman@usda.gov) and Jalisa Sims (jalisa.sims@usda.gov) no later than Thursday, June 25, 2026 by 1:00 PM EST. The questionnaire cannot be submitted by the offeror; it must be received directly from the reference.
The questionnaire evaluates contractor past performance across multiple categories using a six-point rating scale (Excellent, Very Good, Satisfactory, Neutral, Marginal, Unsatisfactory). Key evaluation areas include working relationships, management capability, regulatory compliance, equipment maintenance and operational readiness, personnel management, record-keeping accuracy, environmental and safety compliance, quality standards achievement, quality control procedures, and timeliness of performance. References must provide detailed responses to yes/no questions regarding contractor performance, with explanations required for negative responses. The form also includes space for remarks and additional documentation. This template is associated with the GAOA Buck Hall Recreation Phase 1 Renovation project located in McClellanville, South Carolina, managed by the Department of Agriculture Forest Service.
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Text version
Buck Hall Recreation Site Renovation
PRESENT/PAST PERFORMANCE QUESTIONNAIRE
Offerors are to complete Section A, then forward it to their references.
References shall complete and email to Penny Zortman at penny.zortman@usda.gov and Jalisa Sims at jalisa.sims@usda.gov no later than Thursday, June 25, 2026 by 1pm EST.
Attachment 12 must be received directly from the reference, not the offeror.
SECTION A: CONTRACTOR INFORMATION
A. Contractor’s Name and Address: ________________________________________________
B. Point of Contact: ______________________________________________________________
C. Phone #: ____________________________________________________________________
D. Contract Number: ___________________ Contract Type: ____________________
E. Project Title: _________________________________________________________________
F. Period of Performance: _________________________________________________________
G. Brief Description/Scope of Services provided: _________________________________________
H. Authorization is hereby granted to provide the information requested in SECTION B of this questionnaire.
Signature of Authorized Contractor Representative Date
Printed Name and Title of Authorized Contractor Representative
RESPONDENT INFORMATION:
A. Name:______________________________________ B. Position:________________ C. Telephone Number:_____________________ Fax Number: ______________ D. Address:___________________________ E. Relationship and Time Involved with Contractor:___________________ F. Date Questionnaire Completed:_______________________
| E |
| VG |
| S |
| N |
| M |
| U |
| Excellent |
| Very Good |
| Satisfactory |
| Neutral |
| Marginal |
| Unsatisfactory |
CONTRACT PERFORMANCE
| 1. |
| Working relationship with your Company |
| E |
| VG |
| S |
| N |
| M |
| U |
| 2. |
| Did the contractor provide experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements? If no, please explain. |
| Yes |
No
N/A
| 3. |
| Exhibited knowledge of and compliance with government (or other) regulations and industry standards |
| E |
| VG |
| S |
| N |
| M |
| U |
| 4. |
| Did the contractor provide and properly maintain operational equipment throughout the term of the contract? If no, please explain. |
| Yes |
No
N/A
| 5. |
| Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract? If no, please explain. |
| Yes |
No
N/A
| 6. |
| Does the contractor provide timely and accurate records? |
| Yes |
No
N/A
| 7. |
| How well did the contractor comply with Environmental, Safety, health and security requirements |
| E |
| VG |
| S |
| N |
| M |
| U |
| 8 |
| Would you award similar contracts to this contractor (If no, Please explain in remarks) |
| Yes |
No
N/A
| 9. |
| Contractor’s Overall Performance |
| E |
| VG |
| S |
| N |
| M |
| U |
QUALITY OF SERVICE/CONTROL
| 1. |
| Contractor’s accomplishment in meeting the quality standards |
| E |
| VG |
| S |
| N |
| M |
| U |
| 2. |
| Did the contractor provide an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain. |
| Yes |
No
N/A
| 3. |
| Overall Quality of Service/Control |
| E |
| VG |
| S |
| N |
| M |
| U |
TIMELINESS OF PERFORMANCE
| 1. |
| Was the job/contract started and completed on time?. If not, explain |
| Yes |
No
N/A
| 2. |
| Did the contractor have a system or method to track progress on all work in progress? |
| Yes |
No
N/A
REMARKS: If additional remarks are necessary, please attach an additional sheet.
ATTACHMENT 12
File details come from the government source that posted it. Updated .