Attachment_003_Questionnaire.pdf

Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

Solicitation# 140P5522R0001

Please complete this Questionnaire and e-mail to Lara_Wood@nps.gov

We are currently in the process of preparing our proposal for the National Park Service, Interior

Region 2, Solicitation Number: 140P5522R0001 for the replacement of water pumps, valves and backlow preventers at Acadian Cultural Center, Jean Lafitte National Historic Park and Preserve, Louisiana. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail to Contracting Officer, e-mail:

Lara_Wood@nps.gov

Questionnaire is due to Lara Wood no later than 12:00 PM EST on 21 February 2022.

Questionnaire must be submitted directly to the Contracting Officer from a corporate email account.

If you will not be available on 24 February 2022 for verification (if necessary) of this past performance evaluation, please indicate another POC for the contacting officer to contact.

Alternate POC name:

Alternate POC phone number:

Alternate POC e-mail address:

Thank you.

NAME OF OFFEROR:

Phone: Fax: E-Mail:

Source Selection Information - See FAR 2.101 and 3.104

For Official Use Only mailto:chad_williams@nps.gov mailto:chad_williams@nps.gov

Source Selection Information - See FAR 2.101 and 3.104

For Official Use Only

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance:

4. Brief description of items provided:

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________

II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed.

Attach additional pages if more space is needed.

Evaluation Definitions

The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE (N/A)

Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Past Performance Evaluation

Question 1. Performance

What is your assessment of the Contractor’s ability to meet your requirements?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products in a timely manner?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Timeliness

Ability to

Resolve

Timeliness

Problems

Comments, if any.

Question 4. Quality of Work

What is your assessment of the Contractor’s ability to meet requirements of tasks and the overall quality of the work?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Quality of Work

Comments, if any.

Question 5. Overall Rating of Contractor’s performance

What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

Exceptional Very Good Satisfactory Marginal Unsatisfactory

General Comments:

I.