Attachment_5_-_Past_Performance_Questionnaire.pdf
PDF 192 KB Posted
- Attached to
- GAOA Chain of Lakes Potable Water System
- Solicitation number
- 140L3625R0012
About this file
The document is a Performance Questionnaire for the GAOA Chain of Lakes Potable Water System Replacement contract (Solicitation Number 140L3625R0012). The questionnaire is designed to collect past performance information from contractors for a source selection process, with a response deadline of 8 September 2025. Contractors are asked to email the completed form to Jalvarez@blm.gov.
The questionnaire evaluates contractor performance across seven key areas: quality of products and services, overall performance, technical requirements, schedule adherence, cost control, customer satisfaction, and an overall assessment. Respondents are asked to rate the contractor using a scale from Neutral (N) to Outstanding (O), Better (B), Acceptable (A), or Unacceptable (U). The contract is a fixed-price construction project for replacing potable water lines, irrigation main lines, and installing underground sprinkler systems at multiple campground sites in Lewis and Clark and Cascade Counties, Montana. The procurement is set aside for small businesses, with an estimated contract value between $500,000 and $1,000,000.
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PERFORMANCE QUESTIONNAIRE
140L3625R0012: GAOA Chain of Lakes Potable Water System Replacement
Your assistance is requested in support of a source selection. Please be aware that the procurement office must receive them by the response date below.
Please complete this Questionnaire and email to: Jalvarez@blm.gov
Response Date: Not Later Than 8 September 2025
TO BE COMPLETED BY OFFEROR
1. CONTRACTOR NAME & ADDRESS 2. CONTRACT NO.:
3. CONTRACT INITIATION DATE:
4. COMPLETION DATE:
1a: NAME OF PRIME CONTRACTOR: 5. CONTRACT VALUE (with options): $
6. TYPE OF CONTRACT (fixed price, CMP, FPI, etc.):
7. DESCRIPTION OF CONTRACT REQUIREMENTS:
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION:
a. Evaluator name, position (Project Manager/COR/Other) and organization:
b. Evaluator's Phone Number:
c. Months Performance Monitored by Evaluator:
Please circle response code for each topic (A-G) that best reflects your experience with this contractor.
N = Neutral O= Outstanding B = Better A = Acceptable U = Unacceptable
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 safety and health standards.
N O B A U
B. Performance - Assess the contractor's performance as the General Contractor or Architect/Engineer (as appropriate) for the project.
N O B A U
C. Technical Requirements - Assess the contractor's ability to fulfill the technical requirements of the contract.
N O B A U
D. Schedule - Assess the timeliness of the contractor against the schedule of activities.
N O B A U
E. Cost Control - Assess the contractor's ability to manage the contract budget and control costs.
N O B A U
F. Customer Satisfaction - Assess the contractor's responsiveness to customer concerns and "user friendliness".
N O B A U
G. Overall Assessment
N O B A U
General Comments:
| General Comments: |
| 1: |
| Contractor Name & Address: |
| 1a: |
| Name of Prime Contractor: |
| 2: |
| Contract No: |
| 3: |
| Contract Initiation Date: |
| 4: |
| Completion Date: |
| 5: |
| Contract Value: |
| 6: |
| Type of Contract: Fixed Price |
| 7: |
| Description of Contract Requirements: |
| 8a: |
| Evaluator name, position and organization: |
| 8b: |
| Evaluator's phone number: |
| 8c: |
| Months Performance Monitored by Evaluator: |
File details come from the government source that posted it. Updated .