Exhibit_B_Past_Perf_Quest_P15PS01031(1).pdf

Solicitation No. P15PS01031 PMIS: GOGA 164335 Past Performance Questionnaire

Solicitation No: P15PS01031

Rehabilitate Stinson Beach Wastewater System; Golden Gate National Recreation

Area (GOGA), Marin County, CA

PMIS NO: 164335

PAST PERFORMANCE QUESTIONNAIRE PACKAGE INFORMATION AND FORMS:

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and submit to the owners of the projects in which you have submitted for Prime Contractor Experience, a

Past Performance Reference Package. For Government contracts, send to Contracting Officer. For commercial references send to personnel with duties similar to those for Government contracts. Offerors should follow-up and encourage references to get the questionnaires to the Contracting Officer in a timely manner. If you have multiple references at one location (Park, etc.), send one cover letter and questionnaire for each contract you want a reference for. Your questionnaire package should contain the following:

Cover Letter (See SAMPLE below) (page 1 of this document)

Past Performance Questionnaire (pages 2 and 3 of this document)

Offeror must complete Sections I & II of the questionnaire in the spaces indicated for identification purposes, and reference must complete Sections III & IV.

Suggested - Pre Addressed stamped envelope to return to Contracting Officer.

Please Note:

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE!

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

Solicitation No. P15PS01031 PMIS: GOGA 164335

SAMPLE TRANSMITTAL LETTER AND PAST PERFORMANCE QUESTIONNAIRE

Your Company Letterhead

Date: _________________

To: ______________________________________

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the National Park Service’s, Golden Gate National Recreation

Area. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance.

Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306 (e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to one of the following physical addresses or fax to (415) 561-4795, to arrive NOT LATER THAN THE DUE DATE SET FOR RECEIPT OF PROPOSALS. Do not return them to our company.

If via courier service:

Nathanial Wills

National Park Service

Golden Gate National Recreation Area

Contracting & Procurement

Building 201, Fort Mason

San Francisco, CA 94123

If via U.S. Postal Service:

Nathanial Wills

National Park Service

Golden Gate National Recreation Area

Contracting & Procurement

Building 201, Fort Mason

San Francisco, CA 94123

If you have questions regarding the attached questionnaire, or require assistance, please contact Nathanial Wills at

(415) 561-4707 or email to: nathanial_wills@nps.gov. Thank you for your assistance.

Signature and Title

Solicitation No. P15PS01031 PMIS: GOGA 164335

PAST PERFORMANCE QUESTIONNAIRE

(COMPLETE SECTIONS I AND II AND SUBMIT WITH THE TECHNICAL PROPOSAL)

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO:

CONTRACTOR ADDRESS:

CONTRACT TYPE:

FIRM-FIXED-PRICE

COST REIMBURSEMENT

OTHER: (specify)

ACTIVE COMPLETED

ROUTINE COMPLEX

DATES OF PERFORMANCE:

AWARD AMOUNT: $

TOTAL WITH MODS $

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY (CUSTOMER) NAME:

POC NAME/TITLE/PHONE:

III. PAST PERFORMANCE RATING

Rating Scale: E = Excellent. Considerably surpassed requirements/expectations.

G = Good. Surpassed requirements/expectations.

S = Satisfactory. Met requirements/expectations

M = Marginal. Met some requirements/expectations

U = Unsatisfactory. Did not meet requirements/expectations

1. QUALITY: (Circle applicable rating)

a. Conformance with contract requirements E G S M U

b. Quality of workmanship (including subcontractors) E G S M U

c. General oversight by project manager and superintendent E G S M U

d. Coordination with and control of subcontractors E G S M U

e. Compliance with Davis-Bacon wage rate and labor usage requirements

E G S M U

f. Avoidance of accidents/safety violations E G S M U

Solicitation No. P15PS01031 PMIS: GOGA 164335

2. TIMELINESS:

a. Adherence to project delivery schedules E G S M U

b. Submission of change proposals E G S M U

c. Response to technical direction and change orders E G S M U

d. Response to correction of identified problems E G S M U

e. Submission of timely/accurate/complete billings E G S M U

f. Submission of materials/other submittals E G S M U

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E G S M U

b. Tenacity and innovativeness in resolving problems E G S M U

c. Relationships with subcontractors, including prompt payment E G S M U

d. End user was satisfied with services performed E G S M U

IV. COMMENTS

Required for ratings of C (Considerably Surpassed Requirements) or D (Did Not Meet Requirements)

Item No. Comment

Technical Evaluation Panel Member: Date: