C04_Attachment IV - Past Performance Questionnaire_1232SA26Q1062.doc
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- Attached to
- 1232SA26Q1062-Combination Synopsis/Solicitation for a Cryostat Microtome USDA-ARS-MWA Ames IA
- Solicitation number
- 1232SA26Q1062
About this file
This is a Past Performance Questionnaire template designed for vendors responding to the Cryostat Microtome solicitation issued by the USDA Agricultural Research Service (ARS) Ames, Iowa facility. The questionnaire serves as an evaluation tool to assess potential contractors' relevant experience and track record in delivering similar equipment or services. Vendors must complete this form to demonstrate their capability to meet the agency's requirements for procuring a cryostat microtome used for sectioning snap-frozen animal tissues. The questionnaire is a standard component of the evaluation criteria and helps the government evaluate contractor qualifications alongside technical proposals and pricing submissions.
This attachment is part of solicitation 1232SA26Q1062, issued as an unrestricted Request for Quotation under FAR Part 12 for commercial items. The acquisition is not set-aside for small business, and all responsible sources are eligible to submit quotations. Vendors should complete all required sections of the past performance questionnaire and submit it with their quotation response to support their bid evaluation.
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Attachment IV
Request For Proposal (RFP) # 1232SA26Q1062 USDA-ARS-MWA Ames IA 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 .