Attachment_0014_140L0626R0004_Past_Perf_Questionnaire.docx
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- Attached to
- Meadowood Sensory Nature Trail
- Solicitation number
- 140L0626R0004
About this file
This is a Past Performance Questionnaire template for the Meadowood Sensory Nature Trail contract (140L0626R0004) issued by the Department of the Interior. The form is designed to be completed by references who have direct knowledge of a contractor's performance on similar projects and must be returned by April 17, 2026 to Nathan Roush, Contracting Officer at the Department of Interior, National Operations Center.
The questionnaire requests contractor information including company name, DUNS number, and points of contact, along with contract details such as project title, contract number, contract type, awarded and final prices, award and completion dates, and project location. References must rate contractor performance across five key evaluation areas—Quality, Schedule & Time Management, Pricing and Payments, Management, and Regulatory Compliance—using a six-point scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Applicable). Each evaluation area includes specific assessment questions with space for supporting comments, and references must provide an overall recommendation regarding the contractor's suitability for similar future contracts. The form includes detailed rating definitions to ensure consistent and objective evaluation of past performance.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
140L0626R0004 – MEADOWOOD SENSORY NATURE TRAIL
A. CONTRACTOR INFORMATION
| Company Name |
| Company |
| Street Address |
| Address |
| City |
| City |
| State |
| State |
| Zip Code |
| XXXXX |
| DUNS Number |
| XXXXXXX |
| Point of Contact |
| Name, Email, Phone |
B. CONTRACT INFORMATION
| Project Title |
| Title |
| Contract Number |
| XXXXXXXXXX |
| Contract Type |
| Firm Fixed Price / Time & Materials / Cost Reimbursable / Other |
| Awarded Contract Price |
| $X,XXX,XXX |
| Current / Final Price |
| $X,XXX,XXX |
| Contract Award Date |
| XX/XX/XXXX |
| Contract Completion Date |
| XX/XX/XXXX |
| Project Location |
| Street address, City, State |
| Client / Owner |
| Company |
| Brief description of the contract & work effort: |
| Scope of work description |
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 building and life safety codes?
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:
E. RETURN:
| Return by |
| 17 April 2026 |
| Name |
| Nathan Roush |
| Title |
| Contracting Officer |
| Organization |
| Department of Interior, National Operations Center, OC664 |
| nathan_roush@ios.doi.gov |
File details come from the government source that posted it. Updated .