B08_140P5123Q0034_Attach_0004_PPQ_MALU_Pavement_Preservation.pdf

RFQ #140P5123Q0034 - Attachment 0004

PAST PERFORMANCE QUESTIONNAIRE

Solicitation#140P5123Q0034 Please complete this Questionnaire and Submit with your Quote

We are currently in the process of preparing our proposal for the National Park Service, Interior Region 2 South Atlantic Gulf, Solicitation Number: 140P5123Q0034 to repair and repave the parking lots at Ebenezer Baptist Church and Fire Station. The paving has been in place for nearly 20 years which is beyond the life cycle for asphalt. The work shall consist of applying a preventive maintenance action to the parking lot surface that includes minor spot repairs (patching), crack sealing and the application of a surface seal or non-structural overlay at Martin Luther King, Jr. National Historic Site Atlanta, Georgia per the attached specifications. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below.

Your input on our performance is therefore requested.

Please complete this Questionnaire and submit with your quote

Questionnaire is due to prior to the closing of RFP #140P5123Q0034.

Alternate POC name:

Alternate POC phone number:

Alternate POC e-mail address:

Thank you.

NAME OF OFFEROR:

Phone: ________________________ Fax: _____________________

E-Mail: _______________________

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number:

2. Contract Value:

3. Period of Performance:

4. Brief description of items provided:

5. Name of Person Completing Questionnaire:

Agency/Company:

Title: Phone:

E-mail:

mailto:Please%20complete%20this%20Questionnaire%20and%20e-mail%20to%20edward_dingle@nps.gov mailto:Please%20complete%20this%20Questionnaire%20and%20e-mail%20to%20Contracting%20Officer,%20e-mail:%20edward_dingle@nps.gov

II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions –

The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE (N/A) Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Past Performance Evaluation

Question 1. Performance

What is your assessment of the Contractor’s ability to meet your requirements?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products in a timely manner?

Timeliness

Ability to Resolve Timeliness Problems

Question 4. Quality of Work

What is your assessment of the Contractor’s ability to meet requirements of tasks and the overall quality of the work?

Quality of Shipments

Question 5. Overall Rating of Contractor’s performance

What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

Exceptional Very Good Satisfactory Marginal Unsatisfactory

General Comments: