Exhibit B Past Performance Questionaire.docx
DOCX document 31 KB Posted
- Attached to
- Circuit Rider Technical Assistance Program Federal contract opportunity
- Solicitation number
- 12RADA26R0001
About this file
This is a Past Performance Questionnaire form used by the USDA Rural Development to evaluate contractor performance on the Circuit Rider Technical Assistance Program contract (Solicitation 12RADA26R0001). The questionnaire is designated as source selection sensitive and must be completed by government evaluators who have worked with potential contractors on similar contracts completed within the past three years or currently being performed.
Evaluators must rate contractor performance across multiple dimensions using a five-point scale: Exceptional, Very Good, Satisfactory, Marginal, or Unsatisfactory. Assessment areas include overall project performance, responsiveness and flexibility, experience with government standards and regulations, quality control procedures, timely correction of deficiencies, cooperation with government personnel, and meeting volume orders. Detailed comments are required for any rating below "Very Good" and recommended for other responses. The completed questionnaire must be emailed to Gary.brown3@usda.gov no later than 3:00 PM EST on March 4, 2026. Evaluators must also provide respondent information including name, office location, phone number, position/grade, length of time on the program, and completion date. The form requests supporting documentation such as past performance database reports and information on any adverse performance and corrective actions taken. This is a template form designed to support the source selection process for a 5-year firm-fixed-price services contract for nationwide circuit rider technical support services under the Rural Utilities Service.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions_and_Answers_12RADA26R0001.xlsx | XLSX spreadsheet | |
| 12RADA26R0001_Amd_0001.pdf | ||
| Attachment 3 Subcontracting_Plan_TEMPLATE.docx | DOCX document | |
| Exhibit A Questions and Answer Form.xlsx | XLSX spreadsheet | |
| 12RADA26R0001.pdf | ||
| Attachment 1 PWS - WEP Circuit Rider Technical Assistance Progrm.pdf | ||
| Attachment 2 Pricing Worksheet 12RADA26R0001.xlsx | XLSX spreadsheet | |
| Attachment 4 DISCLOSURE OF LOBBYING ACTIVITIES.pdf |
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Text version
Exhibit B : Past Performance Questionnaire
WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE
IAW RFO 2.101 AND 3.104
SOLICITATION/RFQ: 12RADA26R0001
PROGRAM: Circuit Rider Technical Assistance 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 Circuit Rider Technical Assistance 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. |
| 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. |
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, MARCH 04, 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: _____________________________________ 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
File details come from the government source that posted it. Updated .