B08_Att_06_Past_Performance_Questionnaire.pdf

PDF 519 KB Posted

Attached to
GLCA 210865 Replace Wahweap Government Dock DB Federal contract opportunity
Solicitation number
140P2026R0030
Issued by
Department of the Interior National Park Service National Office

About this file

This is a Past Performance Questionnaire template used by federal contracting officers to collect and evaluate contractor performance information from project references. The document establishes a three-part process: the offeror completes Sections A and B with contractor and contract information, then transmits the questionnaire to a reference who completes Sections C and D and returns it to the contracting officer.

Section A requires the contractor to provide company information including name, address, DUNS number, and 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/final prices, award date, completion date, period of performance, project location, and a brief scope of work description. Section C identifies the reference contact with name, position, organization, phone, email, and signature. Section D contains the evaluation criteria with five assessment areas: Quality (workmanship, quality control, and technical submittals); Schedule & Time Management (milestone achievement, responsiveness, timely submittals, and scheduling); Cost Control (site condition management, modification pricing, invoice accuracy, and subcontractor payment); Management (project oversight, subcontractor coordination, safety, location factors, owner relationships, and problem-solving); Small Business Subcontracting & Labor Standards; and Regulatory Compliance. Each area uses a five-point rating scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory) with detailed definitions. Section E specifies return requirements to Zaira Lupidi, Contracting Officer at the National Park Service – Denver Service Center, with a deadline of 1:00 pm EST March 15, 2026.

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Text version

PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS: Offeror to complete Sections A and B and transmit questionnaire to reference.

Reference 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 other 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 Email Signature Signature Date XX/XX/XXXX

D. EVALUATION

Rating Definition

Exceptional 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 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 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 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 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.

Evaluation Area Rating Quality

Quality of workmanship (including subcontractors)? Choose an item.

Quality of and adherence to quality control plan? Choose an item.

Quality of informational and technical submittals? Choose an item.

Overall Quality Rating Choose an item.

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Schedule (& Time Management) Met project schedule milestones? Choose an item.

Responded to owner requests in a timely manner? Choose an item.

Informational and technical submittals submitted timely? Choose an item.

Promptly addressed scheduling issues? Choose an item.

Overall Schedule (& Time Management) Rating Choose an item.

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Cost Control Addressed differing & unforeseen site conditions so as to minimize additional costs? Choose an item.

Provided fair and reasonable pricing for contract modifications? Choose an item.

Submitted accurate and complete invoices? Choose an item.

Promptly paid subcontractors and suppliers? Choose an item.

Overall Cost Control Rating Choose an item.

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Management General oversight by project manager and superintendent? Choose an item.

Coordination with and control of subcontractors? Choose an item.

Avoidance of accidents & safety violations? Choose an item.

Addressed location factors (especially remote locations)? Choose an item.

Maintained good working relationship with owner representatives? Choose an item.

Demonstrated flexibility, innovativeness and cooperation in resolving potential problems? Choose an item.

Overall Management Rating Choose an item.

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Small Business Subcontracting (& Labor Standards) Met regulatory and contractual labor standards? Choose an item.

Successfully contracted with small and socio-economically disadvantaged businesses? Choose an item.

Quality and adherence to applicable subcontracting plans? Choose an item.

Overall Small Business Subcontracting (& Labor Standards) Rating Choose an item.

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Regulatory Compliance Met building and life safety codes? Choose an item.

Overall Regulatory Compliance Rating Choose an item.

Overall Recommendation:

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: Choose an item.

Overall Comments:

E. RETURN:

Return by Name Title Contracting Officer Organization National Park Service – Denver Service Center Email

1:00 pm EST March 15, 2026 Zaira Lupidi zaira_lupidi@nps.gov

File details come from the government source that posted it. Updated .