C04_Attachment V - Past Performance Questionnaire_1232SA26Q1222.doc
DOC document 39 KB Posted
- Attached to
- 1232SA26Q1222 – RFI Responses Combo Synopsis-Solicitation Steam Sterilizer USDA ARS PA Sidney MT
- Solicitation number
- 1232SA26Q1222
About this file
This is a Past Performance Questionnaire template for RFP #1232SA26Q1222 issued by the USDA Agricultural Research Service for a steam sterilizer acquisition at the Sidney, Montana facility. The questionnaire is designed to be completed jointly by the contractor and their client references to evaluate past performance on relevant projects.
The form requires contractors to provide company information and identify specific client projects, then forward the questionnaire to designated technical and contracting points of contact at client organizations for evaluation. Completed questionnaires must be returned via email to theodore.blume@usda.gov by the stated deadline. The evaluation criteria include technical performance metrics (overall technical performance, quality of work, schedule performance, and cost performance), risk identification and mitigation capabilities, contractual performance, and willingness to use the contractor again. Ratings are scored on a scale of Excellent, Very Good, Good, Fair, Poor, or N/A. The form also requests confirmation that the contractor informed clients of the submission deadline and that USDA representatives may conduct follow-up contact. This is an appendix/template document that does not address specific products or services but rather establishes the evaluation mechanism for contractor past performance.
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Text version
Attachment V
Request For Proposal (RFP) # 1232SA26Q1222 USDA-ARS-PA Sidney MT Attachment V
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 .