B08_ATT_8_PAST_PERFORMANCE_QUESTIONNAIRE_FILLABLE.pdf

Solicitation 140L0622R0035

Past Performance Questionnaire

The U.S. Department of Interior Bureau of Land Management (BLM) has a requirement for a Federal Orphaned Well Program – Support Services Indefinite Delivery Indefinite Quantity (IDIQ) contract. As part of the procurement process, past performance is a source selection factor.

The offeror shall complete the included Past Performance Questionnaire for up to three (3) complete projects performed by the prime contractor within the last (7) seven years that are proposed to be similar scope, magnitude of effort, and complexities. The offeror shall fill out Part I and coordinate completion of Parts II & III with the respective reference. Completed Past Performance Questionnaires shall be included in the offeror’s proposal and not sent directly to the agency.

The offeror is responsible for compiling and submitting completed past performance questionnaires in its proposal, though the Government may contact references to verify the veracity of provided information.

References shall not send completed past performance questionnaires to the Government.

The following standards shall be used in arriving at the rating.

Outstanding Contractor’s performance exceeded customer expectations and was technically acceptable, providing significant features or benefits.

Satisfactory Contractor met customer expectations or contract requirements and demonstrated an acceptable understanding of the requirements.

Unsatisfactory Contractor’s performance was either marginal or did not meet customer expectations or contract requirements.

Other If the element is not applicable, indicate with “N/A.” If no data has been obtained or additional comments are provided, please note in this column.

Past Performance Questionnaire – Part I

NAME OF COMPANY EVALUATED

ADDRESS OF COMPANY EVALUATED

CONTRACT NUMBER

CONTRACT PERIOD OF PERFORMANCE

CONTRACT VALUE

CONTRACT TYPE

CONTRACTING OFFICER NAME,

ADDRESS, FAX AND TELEPHONE NUMBER, AND EMAIL ADDRESS

TYPE OF SERVICES PERFORMED (ACTIVITY)

Past Performance Questionnaire – Part II

NAME OF EVALUATOR, COMPANY/AGENCY,

ADDRESS, FAX AND TELEPHONE NUMBER AND

EMAIL ADDRESS

DATE EVALUATION PROVIDED

Past Performance Questionnaire – Part III

Performance Element Outstanding Satisfactory Unsatisfactory Other

Technical Performance (Quality of Product or Service)

1. QUALITY OF TECHNICAL APPROACH

(For example: Were the services comprehensive, complete, and feasible? (Met the needs, performed successfully, and accommodated changing requirements.)

2. UNDERSTANDING OF REQUIREMENTS

(For example: Did the contractor show an understanding of the scope of the requirements and an appreciation of the complexity of the requirements? And did the contractor effectively identify flaws, inconsistencies and other inaccuracies in your technical direction?)

Timeliness of Performance

3. EFFECTIVE AND EFFICIENT USE OF RESOURCES

(For example: Was the contractor able to obtain in a timely manner the amount and type of personnel resources required to support the project, effectively train personnel to perform the work required for the project, and maintain the required workforce throughout the term of the contract?)

4. TIMELINESS OF PERFORMANCE

(For example: Was the contractor successful in planning and proposing realistic schedules, monitoring performance, completing work on time, and implementing corrections/changes in a timely manner?)

Quality / Customer Satisfaction

5. QUALITY OF PERFORMANCE/CUSTOMER SATISFACTION

(For example: Was the contractor committed to customer satisfaction?)

6. BUSINESS BEHAVIOR

(For example: Was the contractor reasonable and cooperative at the corporate and program levels in response to changes in technical direction, correcting errors, poor performance, criticism/rejection of contract deliverables and other quality issues?)

7. COMMUNICATION

(For example: Did the contractor work and communicate well with contracting officers, contracting officer’s technical representatives, end users, other contractors, subcontractors, and in-house staff?)

Cost Control

8. COST CONTROL

(For example: Was the contractor successful in planning and proposing realistic costs, monitoring performance, operating at or below budget, and implementing corrections/changes in a cost effective manner?)

FOR #9, PLEASE ANSWER “Yes” or “No”, as appropriate YES NO

9. Given the choice, would you do business with this contractor again?

Additional Comment Form

Please provide any additional comments regarding your performance element ratings in the space below. Please add additional pages as necessary.