C04_Attachment 3_Past Performance Questionaire.pdf

Attachment 3: Past Performance Questionnaire

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE

IAW RFO 2.101 AND 3.104

SOLICITATION/RFQ: 12RADZ26R0001

PROGRAM: Multi-family Physical Inspection Program

CONTRACTOR NAME: __________________________

1. Background

The U.S. Department of Agriculture (USDA), Rural Development (RD) is currently in the process of soliciting for a competitive service contract for its Multi-family Physical Inspection Program.

This questionnaire is to obtain past performance information relative to contracts that have previously been completed within the past three years or are currently being performed by the contractor identified above. This company is a potential source for performing a base + four option periods firm fixed priced services contract.

2. Instructions

Please complete the questionnaire based on the following guidance:

A. Handwritten responses are sufficient.

B. Indicate, based on the description below, the contractor’s performance on the identified program in the assessment area. Assessments should reflect only the contractor’s relevant performance. The following is a definition of the scoring levels:

Rating Description

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Check next to the word corresponding to your rating

C. Please provide comments for all questions in which a “Unsatisfactory”, “Marginal”, or “Satisfactory” rating is given and as appropriate for all other answers. Space for your comments is provided in each area. If more space is needed, attach additional sheets to the end of the questionnaire and reference the respective question.

D. You are urged to supplement your own knowledge of the offeror’s performance with the judgement of others in your organization. In addition to completing the attached questionnaire for the program, we solicit your comments on other similar programs for which your office has contracts with this offeror.

E. PLEASE EMAIL YOUR COMPLETE QUESTIONNAIRE WITHIN 7 DAYS AFTER RECEIPT,

BUT NO LATER THAN 3:00 PM EST, August 22, 2026, TO THE FOLLOWING:

Gary.brown3@usda.gov

Your assistance in evaluating the contractor’s past performance is appreciated. Our goal is to select the best value to the Government. Your Past performance evaluation is a consideration in determining the best value.

3. Program Identification:

Evaluator please complete:

A. Contractor: _______________________________________________

B. Contract Number: __________________________________________

C. Estimated contract dollar amount: _____________________________

D. Period of Performance: _____________________________________

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

mailto:Gary.brown3@usda.gov

E. Describe product acquired: ___________________________________

F. Contract Type: ____________________________________________

G. Contract Description: Brief description of the services provided by the contractor for this contract:

Comments:

4. Past Performance Evaluation:

a.. How would you rate the contractor’s overall performance on the project?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

b. How would you rate the contractor’s responsiveness and flexibility?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments

c. How would you rate the contractor’s experience with the Government’s stringent standards/regulations?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

THE CONTRACTOR:

5. Provided effective quality control and/or inspection procedures to meet contract requirements?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

6. Corrected deficiencies in a timely manner?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

7. Cooperated with Government personnel?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

8. Met volume orders in a timely manner?

[ ] Exceptional [ ] Very Good

[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory

Comments:

Knowing what I know about this contractor and in my experience please choose one of the following:

____I would not consider entering into another contract with this contractor

____I might consider entering into another contract with this contractor

____I would consider entering into another contract with this contractor

9. Additional Information, if available:

Please attach any past performance database reports or other material you deem appropriate to a full understanding of the Contractor’s past performance by the evaluator. Please provide information on any adverse performance by the contractor and the corrective actions taken.

10. Respondent Information:

The following information will assist in the analysis of the data and will be kept confidential.

A. Name of Evaluator:

B. Office Symbol/Location:

C. Phone:

D. Position of Title/Grade:

E. Length of Time on Program/Contract:

F. Date Questionnaire Completed

Attachment 3: Past Performance Questionnaire