B08_140P1426R0002_Attachment_7_Past_Performance_Questionnaire.docx
DOCX document 29 KB Posted
- Attached to
- GRTE MORMON ROW LANDSCAPE REHAB
- Solicitation number
- 140P1426R0002
About this file
This is a Past Performance Questionnaire template designed to collect reference information from previous clients regarding a contractor's performance on similar projects. The questionnaire is structured in five sections: Section A requires the contractor to provide company information and a point of contact; Section B requests detailed contract information including project title, contract number, contract type (Firm Fixed Price, Time & Materials, Cost Reimbursable, or Other), awarded and current pricing, award and completion dates, period of performance, project location, and a brief scope of work description. Section C is completed by the reference contact, who provides their name, position, organization, phone number, email, signature, and date.
Section D contains the evaluation criteria, organized into five key assessment areas: Quality (workmanship, quality control adherence, and technical submittals), Schedule and Time Management (milestone achievement, responsiveness, timely submittals, and issue resolution), Cost Control (handling of differing/unforeseen conditions, fair pricing for modifications, invoice accuracy, and prompt payment to subcontractors), Management (project oversight, subcontractor coordination, safety, remote location handling, owner relationships, and problem-solving flexibility), and Small Business Subcontracting and Labor Standards (regulatory compliance, small/disadvantaged business contracting, and subcontracting plan adherence). References rate performance in each area using a five-point scale: Exceptional (E), Very Good (V), Satisfactory (S), Marginal (M), or Unsatisfactory (U). Section E specifies that completed questionnaires should be returned to Molly Lynam, Contract Specialist with the National Park Service Northern Rockies MABO, at molly_lynam@nps.gov, and references the solicitation number 140P1426R0002. The document is marked as Source Selection Sensitive and includes restrictions on contractor use of reference information for promotional purposes.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS: Offeror/contractor to complete Sections A and B and transmit questionnaire to reference/client.
Reference/client to complete Sections C and D and transmit back to Contracting Officer listed in section E.
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.
A. CONTRACTOR INFORMATION
| Company Name |
| Company |
| Street Address |
| Address |
| City |
| City |
| State |
| State |
| Zip Code |
| XXXXX |
| DUNS Number |
| XXXXXXX |
| Point of Contact |
| Name, Email, Phone |
B. CONTRACT INFORMATION
| Project Title |
| Title |
| Contract Number |
| XXXXXXXXXX |
| Contract Type |
| Firm Fixed Price / Time & Materials / Cost Reimbursable / Other |
| Awarded Contract Price |
| $X,XXX,XXX |
| Current / Final Price |
| $X,XXX,XXX |
| Contract Award Date |
| XX/XX/XXXX |
| Contract Completion Date |
| XX/XX/XXXX |
| Period of Performance |
| XX/XX/XXX – XX/XX/XXX |
| Project Location |
| Park or Street address, City, State |
| Client / Owner |
| Company |
| Brief description of the contract & work effort: |
| Scope of work description |
C. REFERENCE:
| Name |
| First, Last |
| Position / Title |
| Title |
| Organization |
| Agency or Company |
| Phone Number |
| XXX-XXX-XXXX |
| Email Address |
| Signature |
| Signature |
| Date |
| XX/XX/XXXX |
D. EVALUATION
| Rating |
| Definition |
Exceptional – “E” Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Very Good – “V” Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
| Satisfactory – “S” |
| Performance met contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| Marginal – “M” |
| Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. |
| Unsatisfactory – “U” |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
Page of 3
| Evaluation Area |
| Rating |
| Quality |
| E |
| V |
| S |
| M |
| U |
Quality of workmanship (including subcontractors)?
Quality of and adherence to quality control plan?
Quality of informational and technical submittals?
Overall Quality Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent (E), marginal (M), & unsatisfactory (U) are especially helpful.):
| Schedule (& Time Management) |
| E |
| V |
| S |
| M |
| U |
Met project schedule milestones?
Responded to owner requests in a timely manner?
Informational and technical submittals submitted timely?
Promptly addressed scheduling issues?
Overall Schedule (& Time Management) Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent (E), marginal (M), & unsatisfactory (U) are especially helpful.):
| Cost Control |
| E |
| V |
| S |
| M |
| U |
Addressed differing & unforeseen site conditions so as to minimize additional costs?
Provided fair and reasonable pricing for contract modifications?
Submitted accurate and complete invoices?
Promptly paid subcontractors and suppliers?
Overall Cost Control Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent (E), marginal (M), & unsatisfactory (U) are especially helpful.):
| Management |
| E |
| V |
| S |
| M |
| U |
General oversight by project manager and superintendent?
Coordination with and control of subcontractors?
Avoidance of accidents & safety violations?
Addressed location factors (especially remote locations)?
Maintained good working relationship with owner representatives?
Demonstrated flexibility, innovativeness and cooperation in resolving potential problems?
Overall Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent (E), marginal (M), & unsatisfactory (U) are especially helpful.):
| Small Business Subcontracting (& Labor Standards) |
| Yes |
| No |
Met regulatory and contractual labor standards?
Successfully contracted with small and socio-economically disadvantaged businesses?
Quality and adherence to applicable subcontracting plans?
Overall Small Business Subcontracting (& Labor Standards) Rating
Comments (Please provide comments supporting the above ratings especially if you responded “No”.)
| Regulatory Compliance |
| Yes |
| No |
Met building and life safety codes?
Overall Regulatory Compliance Rating
| Overall Recommendation: |
| Yes |
| No |
Given what I know today about the contractor's ability to perform in accordance with the contract’s most significant requirements, I would recommend them for similar contracts:
Overall Comments:
E. RETURN:
Return by
| Name |
| Molly Lynam |
| Title |
| Contract Specialist |
| Organization |
| National Park Service – Northern Rockies MABO |
| molly_lynam@nps.gov |
Reference solicitation 140P1426R0002
File details come from the government source that posted it. Updated .