C04_Attachment IV- Past Performance Questionnaire_1232SA26Q0139.doc
DOC document 39 KB Posted
- Solicitation number
- 1232SA26Q0139
About this file
This is a Past Performance Questionnaire template that contractors must complete and submit as part of RFP 1232SA26Q0139 issued by the USDA Agricultural Research Service for the Prairie du Sac, Wisconsin location. The form serves as an attachment to evaluate contractor performance on previous projects and requires two-part completion: Section 1 is completed by the contractor with basic contract and project information, while Section 2 is completed by the client's technical and contracting points of contact who provide performance ratings and recommendations.
The questionnaire assesses contractor performance across multiple dimensions including overall technical performance, quality of work, schedule performance, cost performance, and contractual performance, with ratings ranging from Excellent to Poor or N/A. Additional evaluation criteria include the contractor's ability to proactively identify and mitigate risks and whether the client would use the company again. Contractors are responsible for contacting their referenced clients, distributing the form for completion, and ensuring clients return completed questionnaires via email to theodore.blume@usda.gov by a specified deadline. The form requires contractors to identify personnel contacts and provide detailed project information including scope of work, contract numbers, period of performance, total cost, and the number of personnel assigned by skill category.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Request For Proposal (RFP) # 1232SA26Q0139 USDA-ARS-MWA – Prairie du Sac WI Attachment IV
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
The Contractor shall complete the company specific information on this form, contact their clients, forward this form to their clients and request that their clients complete it (verify/concur and score) and send it via email to theodore.blume@usda.gov
This will expedite the response from each referenced source.
CONTRACTOR COMPLETES SECTION 1. CLIENT POC COMPLETES SECTION 2.
SECTION 1:
Name of Contractor: ______________________________________________________
Name of client organization:
Project name and contract/task order number:
Brief description of support provided:
Total period of performance, dates, and total cost/price:
Number of contractor personnel assigned to the project, by skill category:
Name and Title of Technical Point of Contact (POC):
Address of Technical POC:
Telephone number of Technical POC:
Date the Technical POC was contacted for this PPQ:
Did you inform your client that a past performance questionnaire must be completed and returned to USDA by DATE, and that a USDA representative may contact him/her sometime after that date?
FORMCHECKBOX
Yes FORMCHECKBOX No
SECTION 2:
Please BOLD the rating your Technical POC indicated he/she would give your project if contacted:
1. Overall Technical Performance
| Excellent |
| Very Good |
| Good |
| Fair |
| Poor |
| N/A |
2.
Quality of work
| Excellent |
| Very Good |
| Good |
| Fair |
| Poor |
| N/A |
3.
Schedule Performance
| Excellent |
| Very Good |
| Good |
| Fair |
| Poor |
| N/A |
4.
Cost Performance
| Excellent |
| Very Good |
| Good |
| Fair |
| Poor |
| N/A |
5.
Did the contractor proactively identify risk areas, mitigate risks, and respond to emergency and critical situations? FORMCHECKBOX Yes FORMCHECKBOX No
6.
Would your Technical POC use your company again? FORMCHECKBOX Yes FORMCHECKBOX No
Please BOLD the rating your Contracting POC indicated he/she would give your project if contacted:
1.
Overall Contractual Performance
| Excellent |
| Very Good |
| Good |
| Fair |
| Poor |
| N/A |
2.
Would your Contracting POC use your company again? FORMCHECKBOX Yes FORMCHECKBOX No
Employee(s) who made the contact with above-named client references:
File details come from the government source that posted it. Updated .