Attachment J-3 - Past Performance Questionnaire.doc

DOC document 85 KB Posted May 13, 2026

Attached to: GPO G-Street Sidewalk Repair
Solicitation number: 040ADV-26-R-0010
Issued by: Government Publishing Office

About this file

Written by GovTribe AI · May 13, 2026

This file is a Past Performance Questionnaire template designed to evaluate contractor experience and historical performance on similar projects. The questionnaire serves as an evaluation tool for the G Street Sidewalk and Vault Ceiling Repair Project solicitation issued by the Government Publishing Office under solicitation number 040ADV-26-R-0010.

As a template document, this questionnaire does not contain specific performance requirements or evaluation criteria details, but rather provides the framework through which offerors will be asked to demonstrate their qualifications. Offerors responding to the sidewalk repair solicitation will use this questionnaire to document their past performance on comparable structural repair and restoration projects involving sidewalk and vault ceiling work. The questionnaire is intended to support the Government's evaluation of proposals under the Lowest Price Technically Acceptable (LPTA) criteria, allowing the Government to assess whether prospective contractors possess the requisite experience and track record to successfully execute this Firm Fixed Price contract.

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Other files

File	Type	Posted
040ADV-26-R-0010.pdf	PDF	May 13, 2026
Attachment J-4 -Cost-Price Proposal.xlsx	XLSX spreadsheet	May 13, 2026
Attachment J-1 DWGS.pdf	PDF	May 13, 2026
Attachment J-2 G-Street Sidewalk Repair Spec.pdf	PDF	May 13, 2026
Attachment J-5 DBA Wage Determination Washington DC.pdf	PDF	May 13, 2026

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Attachment J-3 Past Performance Questionnaire

Past Performance Questionnaire

ORGANIZATION’S PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this questionnaire and send by email to: gstevens@gpo.gov and twhite@gpo.gov

U.S. Government Publishing Office Acquisition Services

732 North Capitol Street, NW Room A530, Stop: AS Washington, DC 20401 Response Due Date July 2, 2026, at 5:00 PM EST

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY CONTRACTOR

1. CONTRACTOR’S NAME AND ADDRESS

3. CONTRACT NO.:

CONTRACT DATE:

4. PERIOD OF PERFORMANCE:

4. PACE OF PERFORMANCE:

5. COMPLETION DATE:

6. CONTRACT VALUE $

2. PROJECT NAME:

7. TYPE OF CONTRACT:

8. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:

Please add a continuation page if additional space is necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

9. NAME AND ADDRESS OF EVALUATING ORGANIZATION:

EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other)

EVALUATOR’S PHONE NUMBER

MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please check the response code for each topic that best reflects your experience with this Contractor:

EX = Exceptional VG = Very Good S = Satisfactory MG = Marginal US = Unsatisfactory N/O = Not Observed

Quality of Products and Services- Assess the Contractor’s conformance to contract requirements.

FORMCHECKBOX

N/O

Overall Performance- Assess the Contractor’s overall performance for the project.

FORMCHECKBOX

N/O

Schedule- Assess the timeliness of the Contractor against the schedule of activities (as appropriate).

FORMCHECKBOX

N/O

Technical Requirements- Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.

FORMCHECKBOX

N/O

Cost Control- Assess the Contractor’s willingness and ability to manage the contract budget and control costs.

FORMCHECKBOX

N/O

Subcontracting- Assess the Contractor’s success at complying with subcontracting goals.

FORMCHECKBOX

N/O

Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.

FORMCHECKBOX

N/O

Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.

FORMCHECKBOX

N/O

Repeat Business- Assess the likelihood that you would want this Contractor to perform another contract for you in the near future.

FORMCHECKBOX

N/O

List Contractor’s Weak Points:

List Contractor’s Strong Points:

List any other projects this Contractor has completed for you:

If an award fee contract, what was the average award fee % earned?

File details come from the government source that posted it. Updated May 13, 2026.