Attachment_3_-_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

Solicitation # 140R4021Q0036 - AIS Watercraft Insp. & Decon. IDIQ

Your assistance is requested in support of a source selection. The minimum requirement is three (3) sources that must be received by the Acquisition Management Division no later than the date below.

Response Date: August 23, 2021 Please complete this Questionnaire Email to: jojewia@usbr.gov Make sure to confirm that the Contracting Officer received the email.

Attn: Josephine Ojewia (UC-854) Phone: (801) 524-3876

TO BE COMPLETED BY OFFEROR

1. CONTRACTOR NAME:

ADDRESS:

CITY/ZIP:

1a: NAME OF PRIME CONTRACTOR:

2. CONTRACT NO.:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

6. TYPE OF CONTRACT (Fixed Firm Price, CMP, FPI, etc.):

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

b. Organization Name:

c. Evaluator's Phone Number:

d. Evaluator’s email:

e. Months Performance Monitored by Evaluator:

*** See page 2 of 2 for additional questions ***

Please check the response for each topic (A-G) that best reflects your experience with this contractor.

A. Quality of Products and Services - Assess the contractor's conformance to contract requirements, specifications and standards of good workmanship (e.g., technical, professional, environmental or health and safety standards.

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

B. Performance - Assess the contractor's performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

C. Technical Requirements - Assess the contractor's ability to fulfill the technical requirements of the contract.

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

D. Schedule - Assess the timeliness of the contractor against the schedule of activities.

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

E. Cost Control - Assess the contractor's ability to manage the contract budget and control costs.

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

F. Customer Satisfaction - Assess the contractor's responsiveness to customer concerns and "user friendliness".

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

G. Overall Assessment

☐ Neutral ☐ Outstanding ☐ Better ☐ Satisfactory ☐ Marginal

Additional Comments: