Attachment_5_-_Past_Performance_Questionnaire.pdf
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- Solicitation number
- 140L3622R0002
About this file
This document contains a federal contract solicitation and opportunity notice. The Department of Interior Bureau of Land Management Montana State Office is soliciting proposals to plug and abandon four existing oil and gas wells and perform site reclamation in Fall River County, South Dakota. The estimated price range for the contract is between $500,000 and $1,000,000. The work must be completed by September 30, 2022. Offerors should submit proposals in response to solicitation number 140L3622R0002 by May 16, 2022. The government anticipates awarding a firm-fixed price contract to the best valued offeror on or around June 12, 2022. The North American Industry Classification System code for this opportunity is 213112 and it is set aside for small businesses with a size standard of $41.5 million.
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Solicitation No: 140L3622R0002 PROJECT DESCRIPTION: L&J Orphan Well Plug, Abandonment, and Reclamation Program
Department of Interior Past Performance Questionnaire (PPQ)
U.S. Department of the Interior, Bureau of Land Management 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.
Solicitation No: 140L3622R0002 PROJECT DESCRIPTION: L&J Orphan Well Plug, Abandonment, and Reclamation Program
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
A
S
M
U
2. Overall corporate management, integrity, reasonableness, and cooperative conduct:
3. Quality control:
4. Ability to meet the performance schedule:
5. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:
Yes
No
6. Would you award another contract to the company being evaluated? If no, please explain:
7. Was the customer satisfied with the final product and services? If no, please explain:
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?
9. Overall Rating
10. Comments
Signatures
Name Date:
| Project Title: |
| Location: |
| Description: |
| Contract Number: |
| Start Date: |
| Completion Date: |
| Initial Amount: |
| Final Amount: |
| Evaluator Name: |
| CompanyAgency Name: |
| Address: |
| POC Email: |
| Position Held or Function in Relation to Project: |
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| Yes: |
| No: |
| 6 Would you award another contract to the company being evaluated If no please explain: |
| Yes_2: |
| No_2: |
| 7 Was the customer satisfied with the final product and services If no please explain: |
| Yes_3: |
| No_3: |
| 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_4: |
| No_4: |
| 9 Overall Rating: |
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| 10 Comments: |
| Date: |
| Company Name: |
| 5: |
| Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:: |
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