C04_Attachment IV - Past Performance Questionnaire_1232SA26Q0817.doc
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- Solicitation number
- 1232SA26Q0817
About this file
This is a Past Performance Questionnaire template for the solicitation of an automated multichannel isothermal microcalorimeter for the USDA Agricultural Research Service (ARS) facility in Starkville, Mississippi. The questionnaire serves as an appendix to the Request for Quotation (RFQ) 1232SA26Q0817 and does not address specific product or service requirements beyond establishing the evaluation criteria for past performance. Rather than detailing deliverables or technical specifications, this attachment functions as a standardized evaluation tool to assess potential contractors' relevant experience and performance history on similar government contracts and commercial projects. Respondents would use this questionnaire to demonstrate their qualifications and track record in providing comparable equipment or services, which would be evaluated as part of the overall proposal assessment for this small business set-aside acquisition under NAICS code 334516.
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Text version
Request For Proposal (RFP) # 1232SA26Q0817 USDA-ARS-SEA Starkville MS 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 .