B08_Attachment_7_Past_Performance_Questionnaire.docx

DOCX document 45 KB Posted

Attached to
HAFE 242454, Pavement Preservation Project Federal contract opportunity
Solicitation number
140P2026R0064
Issued by
Department of the Interior National Park Service National Office

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Written by GovTribe AI ·

This is a Past Performance Questionnaire template for federal contract solicitation 140P2026R0064, a Pavement Preservation Project (HAFE 242454) issued by the National Park Service Denver Service Center. The questionnaire is designed to collect references and past performance evaluations from contractors bidding on the project.

The form requires offerors to provide company information, contact details, and Unique Entity Identifier (UEI) number in Section A, followed by details of a past project demonstrating relevant experience in Section B, including contract number, type, award price, final price, award date, completion date, and period of performance. References identified by the offeror must complete Sections C and D, providing their name, title, organization, phone, email, and signature. Section D contains a structured evaluation framework assessing performance across six categories: Quality (workmanship, quality control, technical submittals), Schedule and Time Management (milestone adherence, responsiveness, timeliness), Cost Control (site conditions, pricing modifications, invoicing accuracy, subcontractor payments), Management (project oversight, subcontractor coordination, safety, owner relations, problem-solving), Small Business Subcontracting and Labor Standards (regulatory compliance, disadvantaged business engagement), and Regulatory Compliance (building and life safety codes). Each category uses a five-point rating scale from Exceptional to Unsatisfactory, with supporting comments required, particularly for Exceptional, Marginal, and Unsatisfactory ratings. Completed questionnaires must be returned to Contracting Officer Rachel Dyer at the National Park Service Denver Service Center by the proposal due date.

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B08_Attachment_8_Experience_Form.docx DOCX document
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PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NO. 140P2026R0064

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 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.

A. OFFEROR INFORMATION

Company Name
Company
Street Address
Address
City
City
State
State
Zip Code
XXXXX
Unique Entity Identifier (UEI) Number / SAM
XXXXXXX
Point of Contact
Name, Email, Phone

B. CONTRACT INFORMATION FOR PAST PROJECT (PROJECT SUBMITTED UNDER PROJECT EXPERIENCE)

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
Proposal due date
Name
Rachel Dyer
Title
Contracting Officer
Organization
National Park Service – Denver Service Center
Email
Rachel_dyer@nps.gov

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