Attachment_No__11_-_Past_Performance_Questionnaire.docx
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- Solicitation number
- 140P8523R0001
About this file
This document contains a past performance questionnaire for a federal construction contract opportunity. The National Park Service is soliciting past performance information from a minimum of three previous clients for whom the contractor has performed relevant work. The questionnaire requests details on the contract, including type, dates of performance, award amount, description of work, and ratings for quality, timeliness, and business relations on a scale of Excellent, Good, Satisfactory, Marginal, and Unsatisfactory. Comments must be provided for any Marginal or Unsatisfactory ratings to allow the contractor to address negative past performance. The completed questionnaire must be returned to the National Park Service contact by the closing date for Solicitation Number 140P8523R0001, which is to construct a new entrance station to reduce traffic at an unspecified National Park location.
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Text version
DEPARTMENT OF THE INTIORIOR – NATIONAL PARK SERVICE
PAST PERFORMANCE QUESTIONNAIRE
Solicitation # 140P8523R0001 Please send completed questionnaire to: jara_woodard@nps.gov by: [Solicitation Closing Date] Notice to Contractor Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise.
This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services.
The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.
Instructions to Contractor Please send this questionnaire to a minimum of three (3) previous clients/agencies in which past performance is obtainable. Have them complete the below portion of this form and return to the beforementioned NPS employee by the date indicated above.
CONTRACT IDENTIFICATION
| CONTRACTOR NAME: |
| CONTRACT NO: |
CONTRACTOR ADDRESS:
CONTRACT TYPE:
|_| FIRM-FIXED-PRICE
|_| COST REIMBURSEMENT
|_| OTHER: (specify)
|_| ACTIVE |_| COMPLETED
|_| ROUTINE |_| COMPLEX
DATES OF PERFORMANCE:
AWARD AMOUNT:
TOTAL WITH MODS:
PROJECT DESCRIPTION:
AGENCY (CUSTOMER) IDENTIFICATION
AGENCY (CUSTOMER) NAME:
POC NAME/TITLE/PHONE:
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. QUALITY: |
| (Circle applicable rating) |
| a. Conformance with contract requirements |
| E G S M U |
| b. Quality of workmanship (including subcontractors) |
| E G S M U |
| c. General oversight by project manager and superintendent |
| E G S M U |
| d. Coordination with and control of subcontractors |
| E G S M U |
| e. Compliance with Davis-Bacon or other wage rate and labor usage requirements |
| E G S M U |
| f. Avoidance of accidents/safety violations |
| E G S M U |
2. TIMELINESS:
| a. Adherence to project delivery schedules |
| E G S M U |
| b. Submission of change proposals |
| E G S M U |
| c. Response to technical direction and change orders |
| E G S M U |
| d. Response to correction of identified problems |
| E G S M U |
| e. Submission of timely/accurate/complete billings |
| E G S M U |
| f. Submission of materials/other submittals |
| E G S M U |
3. BUSINESS RELATIONS:
| a. Flexibility and cooperativeness in resolving problems |
| E G S M U |
| b. Tenacity and innovativeness in resolving problems |
| E G S M U |
| c. Relationships with subcontractors, including prompt payment |
| E G S M U |
| d. End user was satisfied with services performed |
| E G S M U |
Provide comments related to any rating of M = MARGINAL AND U = UNSATISFACTORY. Also, please indicate if any rating of “M” or “U” has been provided to the contractor to allow them to address the negative past performance associated with this requirement.
| PRINTED NAME: |
| DATE: |
SIGNATURE:
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