Att_06-_PP_Questionnaire.pdf

Att 06- Past Performance 140P8421R0010

Offeror Name:

National Park Service

PAST PERFORMANCE QUESTIONNAIRE PACKAGE INFORMATION AND FORMS:

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and submit to the owners of the projects in which you have submitted for Prime/Sub Contractor Experience, a Past Performance Reference Package. For Government contracts, send to Contracting Officer.

For commercial references send to personnel with duties similar to those for Government contracts. Offerors should follow-up and encourage references to get the completed questionnaires to the Contracting Officer before the closing date and time of the solicitation. If you have multiple references at one location (Park, etc.), send one cover letter and questionnaire for each contract you want a reference for. Your questionnaire package should contain the following:

Cover Letter (See SAMPLE below) (page 2 of this document)

Past Performance Questionnaire (pages 3 and 4 of this document) Offeror must complete Sections I & II of the questionnaire in the spaces indicated for identification purposes, and reference must complete Sections III & IV.

Suggested – email directly to Contracting Officer at elizabeth_chico@nps.gov

Please Note:

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE!

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

SAMPLE TRANSMITTAL LETTER AND PAST PERFORMANCE QUESTIONNAIRE

Your Company Letterhead Date:

To:

We have listed your firm as a reference for the work we as the prime contractor, or one of our proposed subcontractors, has performed for your firm as listed in Section I of the attached Past Performance Questionnaire.

Our firm has submitted a proposal under a project advertised by the National Park Service (Re-Roofing of Multiple Buildings at Channel Islands National Park); responses are due to the Contracting Office no later than 2:00 PM PT on September 2, 2021.

In accordance with the Federal Acquisition Regulation (FAR), they will evaluate our firm's (and any proposed subcontractor’s) past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306 (e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to the following email to: elizabeth_chico@nps.gov to arrive NOT LATER THAN SEPTEMBER 2, 2021 at 2:00 PM PT. Do not return them to our company.

If you have questions regarding the attached questionnaire, or require assistance, please contact Elizabeth Chico via telephone (530) 595-6113 or email at elizabeth_chico@nps.gov. Thank you for your assistance.

E

G

G

S

S

M

M

U

U

N

G

S

M

U

PAST PERFORMANCE QUESTIONNAIRE

(OFFEROR COMPLETE SECTIONS I & II AND PRIOR CUSTOMER/REFERENCE

COMPLETE SECTIONS III & IV AND SEND TO CONTRACTING OFFICER)

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO:

CONTRACTOR ADDRESS: CONTRACT TYPE: FIRM-

FIXED-PRICE COST

REIMBURSEMENT

OTHER: (specify)

ACTIVE COMPLETED

ROUTINE COMPLEX

DATES OF PERFORMANCE: AWARD AMOUNT: $

TOTAL WITH MODS $

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY (CUSTOMER) NAME:

POC NAME/TITLE/PHONE:

III. PAST PERFORMANCE RATING

Rating Scale: E = Excellent. Considerably surpassed requirements/expectations.

G = Good. Surpassed requirements/expectations.

S = Satisfactory. Met requirements/expectations M = Marginal. Met some requirements/expectations U = Unsatisfactory. Did not meet requirements/expectations N = Neutral/Unrated. No record of past performance is available – no points of contact could be reached.

1. QUALITY: (Circle applicable rating)

a. Conformance with contract requirements

b. Quality of workmanship (including subcontractors)

c. General oversight by project manager and superintendent

d. Coordination with and control of subcontractors

e. Compliance w/Davis-Bacon wage rate & labor usage requirements

f. Avoidance of accidents/safety violations

2. TIMELINESS:

a. Adherence to project delivery schedules E G S M U N

b. Submission of change proposals E G S M U N

c. Response to technical direction and change orders E G S M U N

d. Response to correction of identified problems E G S M U N

e. Submission of timely/accurate/complete billings E G S M U N

f. Submission of materials/other submittals E G S M U N

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E G S M U N

b. Tenacity and innovativeness in resolving problems E G S M U N

c. Relationships with subcontractors, including prompt payment E G S M U N

d. End user was satisfied with services performed E G S M U N

IV. COMMENTS

Required for ratings of E (Considerably Surpassed Requirements) or U (Did Not Meet Requirements)

Item No. Comment

Evaluator Name and Title (typed or neatly written):

Evaluator Signature:

Date: