Attachment_4_-_Past_Performance_Questionnaire_.doc

DOC document 97 KB Posted

Attached to
REPLACE WATER TREATMENT FACILITY COMPONE Federal contract opportunity
Solicitation number
140P4324R0016
Issued by
Department of the Interior National Park Service Northeast Region

About this file

This document is a Department of the Interior Past Performance Questionnaire (PPQ) regarding a company's past performance on a federal contract. The questionnaire covers the firm's relationship with the client, corporate management, quality control, ability to meet schedule, and overall performance on the project. It asks the evaluator to rate the firm's performance in several areas and provide comments. The questionnaire also asks whether the customer was satisfied with the final product and services, and if the firm was given an opportunity to discuss any negative comments or ratings.

The related federal contract opportunity is for replacing water treatment facility components at Assateague Island National Seashore, issued by the Department of the Interior National Park Service Northeast Region. The solicitation number is 140P4324R0016.

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Text version

Department of Interior

Past Performance Questionnaire (PPQ)

U.S. Department of the Interior, National Park Service is considering [Insert Company].

Your comments would be appreciated regarding this company’s past performance.

Firm Information

Project Title:

Location:

Description:

Company Name:
Contract Number:
Start Date:
Completion Date:
Initial Amount:
Final Amount:

Evaluator

Evaluator Name:
Company/Agency Name:
Address:
POC Email:

Position Held or Function in Relation to Project:

Ratings Overview

Rating: If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“O”
Outstanding
Performance greatly exceeded the contract requirements.
“A”
Above Average
Performance exceeded the contract requirements.
“S”
Satisfactory
Performance met the contract requirements.
“M”
Marginal
Performance met the minimum contract requirements but

Some material aspects of the contractor’s performance were less than satisfactory.

“U”
Unacceptable
Performance was poor and/or did not satisfy contract requirements.

Questionnaire

Please select the appropriate rating and provide supporting information for the following questions.

1. The relationship between the company and client’s/customer’s contract team:
O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

FORMCHECKBOX

2. Overall corporate management, integrity, reasonableness, and cooperative conduct:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

3. Quality control:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

4. Ability to meet the performance schedule:

O

FORMCHECKBOX

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

5. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:

Yes

FORMCHECKBOX

No

6. Would you award another contract to the company being evaluated? If no, please explain:

Yes

No

7. Was the customer satisfied with the final product and services? If no, please explain:
Yes

No

8. Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings? If so, what were the results?

Yes

FORMCHECKBOX

No

9. Overall Rating

O

A

FORMCHECKBOX

S

FORMCHECKBOX

M

FORMCHECKBOX

U

10. Comments

Signatures

Name
Date:

File details come from the government source that posted it. Updated .