B08_ATTACHMENT_005_-_Past_Performance_Questionnaire.pdf

SOL 140P5326R0022-

PAST PERFORMANCE QUESTIONNAIRE

Solicitation# 140P5326R0022 Please complete this Questionnaire and e-mail to marilia_mateo@ios.doi.gov

We are currently in the process of preparing our proposal for the Department of the Interior, National Park Service, Contracting Operations East, South Contracting Office, Solicitation Number:

140P5326R0022 for the Roadway Striping of GRSM. As part of our proposal, we have listed you as a reference for our performance for this type of construction service with your agency 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, e-mail:

marilia_mateo@ios.doi.gov.

Questionnaire is due to Marilia Mateo no later than 12:00 P.M. EDT on Thursday, August 27, 2026.

The questionnaire must be submitted directly to the Contracting Officer from a corporate email account.

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.

If you will not be available for verification (if necessary) of this past performance evaluation, please indicate another POC for the contracting officer to contact.

Alternate POC name: ________________________________________

Alternate POC phone number: _________________________________

Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR BEING RATED:

Phone:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________ mailto:yujeiry_eusebio@ios.doi.gov

3. Period of Performance:

4. Brief description of items 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.

5BEXCEPTIONAL

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

0BVERY 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.

1BSATISFACTORY

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.

2BMARGINAL

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.

3BUNSATISFACTORY

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

4BNOT APPLICABLE (N/A) Performance information not recent or relevant as defined in the Solicitation. Unable to provide an 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 6BN/A

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products promptly?

Exceptional Very Good Satisfactory Marginal Unsatisfactory 7BN/A

Timeliness Ability to Resolve Timeliness Problems

Comments, if any.

Question 4. Quality of Work

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

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Quality of Shipments

Comments, if any.

Question 5. Overall Rating of Contractor’s performance

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

Exceptional Very Good Satisfactory Marginal Unsatisfactory

General Comments: