B08_Att_10_-_Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Solicitation# 140L3722R0017

Please complete this Questionnaire and e-mail it to the Contract Specialist

Traci Thaler at tthaler@blm.gov

We are currently in the process of preparing a proposal for the Bureau of Land Management Manual

Fuels Management Solicitation Number 140L3722R0017. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency/company under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail it to the Contracting Officer, Traci Thaler at tthaler@blm.gov.

The Questionnaire is due to Ms. Thaler, no later than 13:00 Mountain Daylight Time on Monday, August

11, 2022. The questionnaire must be submitted directly to Ms. Thaler from a corporate email account.

Please put the Solicitation #140L3722R0017 in the subject line.

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 services provided:

5. Name of Person Completing Questionnaire:

Agency/Company:

Title: Phone:

E-mail:

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.

mailto:tthaler@blm.gov.

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 the services in a timely manner? If problems arose were they resolved timely? Were they communicated effectively?

Timeliness

Ability to Resolve

Timeliness

Problems

Communication

Question 4. Meeting Requirements

What is your assessment of the Contractor’s ability to meet the requirement (including equipment utilized, work force, experience, safety, etc.) and the overall quality of the work?

Quality of Work

Appropriate

Equipment

Work Force

Safety

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: