Attachment_4_-_Past_Performance_Questionnaire.doc

DOC document 76 KB Posted

Attached to
Remove and install gas-fired water boilers at YELL Federal contract opportunity
Solicitation number
140P1423R0021
Issued by
Department of the Interior National Park Service Intermountain Region

About this file

This document contains a past performance questionnaire template for federal contractors to send to references as part of a proposal submission. The past performance questionnaire requests information about a contractor's previous work on a project, including ratings for product quality, technical ability, adherence to specifications, cost control, schedule performance, project team performance, documentation, and compliance with safety and warranty requirements. Contractors are instructed to fill out sections identifying the contract and agency information before sending it to references associated with prior projects listed in their proposals. References are asked to return the completed questionnaires by May 20, 2023 to the National Park Service for consideration in evaluating proposals. The related federal contract opportunity is for removing and installing gas-fired water boilers at Yellowstone National Park under Solicitation 140P1423R0021 issued by the Department of the Interior National Park Service Intermountain Region.

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Sol_140P1423R0021_Amd_0002.pdf PDF
Sol_140P1423R0021_Amd_0001.pdf PDF
Attachment_2_-_Photo_Boiler_2_HRC.jpg JPG image
Attachment_1_-_Statement_of_Work.docx DOCX document
Sol_140P1423R0021.pdf PDF
Attachment_3_-_Wage_Determination.pdf PDF
Attachment_5_-_Limitation_on_Subcontracting_Worksheet.docx DOCX document

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Text version

ATTACHMENT 7

PAST PERFORMANCE QUESTIONNAIRE PACKAGE INFORMATION AND FORMS

Repair, Replace and Install New Fence

Grand Teton National Park and John D. Rockefeller, Jr. Memorial Parkway Solicitation No. 140P1423R0007 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 or Technical Representative. For commercial references send to personnel with duties similar to those for Government contracts. Offerors should follow-up and encourage references to get the questionnaires to the Contracting Officer in a timely manner. 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 1 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 - Pre Addressed stamped envelope to return to Contracting Officer.

Please Note:

OFFEROR SHOULD PLACE HIS/HER 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 have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the National Park Service. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm'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 via fax, email or to one of the following addresses. Questionnaires are to arrive to the National Park Service NO LATER THAN 05/20/2023. Do not return them to our company.

Email: stacy_vallie@nps.gov If you have questions regarding the attached questionnaire, or require assistance, please contact Stacy Vallie at Stacy_Vallie@nps.gov. Thank you for your assistance.

Signature and Title

PAST PERFORMANCE QUESTIONNAIRE

(COMPLETE SECTIONS I AND II AND SUBMIT WITH THE TECHNICAL PROPOSAL)

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME:
CONTRACT NO:

CONTRACTOR ADDRESS:

CONTRACT TYPE:

FORMCHECKBOX

FIRM-FIXED-PRICE

FORMCHECKBOX

COST REIMBURSEMENT

FORMCHECKBOX

OTHER: (specify)

FORMCHECKBOX

ACTIVE

FORMCHECKBOX

COMPLETED

FORMCHECKBOX

ROUTINE

FORMCHECKBOX

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

1. Technical Evaluation Factor 3:
(Circle applicable rating)
a. PRODUCT QUALITY
E G S M U
b. TECHNICAL ABILITY
E G S M U
c. ADHERENCE TO THE SPECIFICATIONS
E G S M U
d. COST CONTROL
E G S M U
e. CONSTRUCTION SCHEDULE
E G S M U
f. PROJECT TEAM PERFORMANCE
E G S M U
g. PROJECT DOCUMENTATION
E G S M U
h. COMPLIANCE WITH SAFETY & WARRANTY WORK
E G S M U

IV. COMMENTS

Required for ratings of C (Considerably Surpassed Requirements) or D (Did Not Meet Requirements)

Item No.
Comment
Technical Evaluation Panel Member:
Date:

Solicitation No. 140P1423R0007

Past Performance Questionnaire

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