Past_Performance_Questionnaire.pdf

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Attached to
MBIC BOILER REPLACEMENT
Solicitation number
140L3626Q0011
Issued by

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This is a Past Performance Questionnaire (PPQ) form used by the U.S. Department of the Interior, Bureau of Land Management for Solicitation No. 140L3626Q0011 regarding the Ft. Benton Boiler Repair project. The form is a template designed to collect evaluator feedback on a contractor's past performance on a specific project. It requests firm information including project title, location, description, company name, contract number, start and completion dates, initial and final contract amounts, and evaluator details such as name, company/agency, address, email, and position held in relation to the project.

The questionnaire contains ten evaluation items that require respondents to rate contractor performance using a five-point scale: "O" (Outstanding), "A" (Above Average), "S" (Satisfactory), "M" (Marginal), and "U" (Unacceptable). Evaluators assess the company's relationship with the client's contract team, corporate management and integrity, quality control, ability to meet performance schedules, and provide yes/no responses regarding issuance of cure notices or terminations, likelihood of awarding future contracts, customer satisfaction, and whether the firm was given opportunity to respond to negative comments. The form concludes with an overall rating section and space for comments, followed by signature and date fields for the evaluator.

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Sol_140L3626Q0011_Amd_0002.pdf PDF
Sol_140L3626Q0011_Amd_0001.pdf PDF
Answers_to_RFIs_3-30_0001.docx DOCX document
Sol_140L3626Q0011.pdf PDF
WD_2015-5397_rev_27.pdf PDF
SOW_MBIC_Boiler_Replacement_revised_3-17-26.docx DOCX document

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Solicitation No: 140L3626Q0011 PROJECT DESCRIPTION: Ft. Benton Boiler Repair

Department of Interior Past Performance Questionnaire (PPQ)

U.S. Department of the Interior, Bureau of Land Management is considering [Insert Company].

Your comments would be appreciated regarding this company’s past performance.

Firm Information Project Title:

Location:

Description:

Company Name: Contract Number:

Start Date: Completion Date:

Initial Amount: Final Amount:

Evaluator Evaluator Name: Company/Agency Name:

Address: POC Email:

Position Held or Function in Relation to Project:

Ratings Overview Rating: If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“O” Outstanding Performance greatly exceeded the contract requirements.

“A” Above Average Performance exceeded the contract requirements.

“S” Satisfactory Performance met the contract requirements.

“M” Marginal Performance met the minimum contract requirements but

Some material aspects of the contractor’s performance were less than satisfactory.

“U” Unacceptable Performance was poor and/or did not satisfy contract requirements.

Questionnaire Please select the appropriate rating and provide supporting information for the following questions.

1. The relationship between the company and client’s/customer’s contract team:

O A S M U

2. Overall corporate management, integrity, reasonableness, and cooperative conduct:

O A S M U

3. Quality control: O A S M U

4. Ability to meet the performance schedule: O A S M U

5. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:

Yes No

6. Would you award another contract to the company being evaluated? If no, please explain: Yes No

7. Was the customer satisfied with the final product and services? If no, please explain: Yes No

8. Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings? If so, what were the results?

Yes No

9. Overall Rating O A S M U

10. Comments

Signatures Name Date:

Project Title:
Location:
Description:
Company Name:
Contract Number:
Start Date:
Completion Date:
Initial Amount:
Final Amount:
Evaluator Name:
CompanyAgency Name:
Address:
POC Email:
Position Held or Function in Relation to Project:
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Yes:
No:
6 Would you award another contract to the company being evaluated If no please explain:
Yes_2:
No_2:
7 Was the customer satisfied with the final product and services If no please explain:
Yes_3:
No_3:
8 Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings If so what were the results:
Yes_4:
No_4:
9 Overall Rating:
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10 Comments:
Date:
[Insert Company}:
5:
Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain::

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