Attach_15_-_Past_Performance_Questionnaire.docx
DOCX document 35 KB Posted
- Solicitation number
- 140L0623R0021
About this file
This document contains a past performance questionnaire for a federal solicitation. The Bureau of Land Management is seeking proposals for plugging and abandoning the Tulageak Test Well #1 and reserves in the National Petroleum Reserve Alaska. Offerors must provide completed past performance questionnaires from up to three similar projects performed as the prime contractor within the last seven years. The questionnaire includes sections for contractor information, contract details, reference evaluation of quality, schedule, pricing, management, and regulatory compliance on a scale of exceptional to unsatisfactory. References are asked if they would recommend the contractor for future similar contracts.
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PAST PERFORMANCE QUESTIONNAIRE
The U.S. Department of Interior Bureau of Land Management (BLM) has a requirement for National Petroleum Reserve Alaska (NPRA) Legacy Well Remediation – Tulageak Test Well #1 and Reserves. As part of the procurement process, past performance is a source selection factor.
The offeror shall complete the included Past Performance Questionnaire for up to three (3) complete projects performed by the prime contractor within the last (7) seven years that are proposed to be similar scope, magnitude of effort, and complexities. The offeror shall fill out Part A & B and coordinate completion of Parts C & D with the respective reference. Completed Past Performance Questionnaires shall be included in the offeror’s proposal and not sent directly to the agency.
The offeror is responsible for compiling and submitting completed past performance questionnaires in its proposal, though the Government may contact references to verify the veracity of provided information. References shall not send completed past performance questionnaires to the Government.
A. CONTRACTOR INFORMATION
Company Name
Street Address
City
State
Zip Code
UEI Number
Point of Contact
B. CONTRACT INFORMATION
Project Title
Contract Number
Contract Type
Awarded Contract Price
Current / Final Price
Contract Award Date
Contract Completion Date
Project Location
Client / Owner
Brief description of the contract & work effort:
C. REFERENCE:
Name
Position / Title
Organization
Phone Number
Email Address
Signature
Date
D. EVALUATION
| Rating |
| Definition |
| Exceptional (EX) |
| Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| Very Good (VG) |
| Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory (S) |
| Performance met contractual requirements. The element being assessed contained some minor problems for which corrective actions taken by the contractor were satisfactory. |
| Marginal (M) |
| Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective action. |
| Unsatisfactory (U) |
| Performance did not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions were ineffective. |
Not Applicable (NA)
The element does not pertain to the subject project as a result of specific contract and/or project requirements.
| Evaluation Area |
| Rating |
Quality
Quality of workmanship (including subcontractors)?
Quality of and adherence to quality control plan?
Quality of informational and technical submittals?
Overall Quality Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Schedule & Time Management
Met project schedule milestones and/or deadlines?
Responded to owner requests in a timely manner?
Informational and technical submittals submitted timely?
Promptly addressed scheduling issues?
Overall Schedule & Time Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Pricing and Payments
Minimized additional costs when addressing differing & unforeseen site conditions?
Provided fair and reasonable pricing for contract modifications?
Submitted accurate and complete invoices?
Promptly paid subcontractors and suppliers?
Overall Pricing and Payment Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Management
General oversight by project manager and superintendent?
Coordination with and control of subcontractors?
Avoidance of accidents & safety violations?
Addressed location factors (especially remote locations)?
Maintained good working relationship with owner representatives?
Demonstrated flexibility, innovativeness and cooperation in resolving potential problems?
Overall Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Regulatory Compliance
Met local and/or Federal requirements for plugging & abandonment?
Met regulatory and contractual labor standards?
Overall Regulatory Compliance Rating
Overall Recommendation:
Given what I know today about the contractor's ability to perform in accordance with the contract’s most significant requirements, I would recommend them for similar contracts:
Overall Comments:
Solicitation 140L0623R0021 | Page 1 of 3
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