RFP_ATT_12_-_PPQ__7_2_2026.docx

Attachment No. 12 Past Performance Questionnaire (PPQ) Document No.

140L0125R0010 Document Title WHBP Support Services:

ORP in 4 States

ATT 12-8

SOURCE SELECTION SENSITIVE WHEN COMPLETED

*** NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS ***

Past Performance Questionnaire (PPQ)

U.S. Department of the Interior-Bureau of Land Management is considering the firm listed below. Your comments would be appreciated regarding this firm’s past performance.

Instructions: Block A items to be filled out by Offeror. Blocks B and C by the Evaluator/Reference.

BLOCK A: items No. 1 to 20, to be filled out by Offeror - Past Performance Information:

1. Name of Firm Being Evaluated:

2. Address

3. Email:

4. Phone No.:

5. Unique Entity ID:

6. Principal NAICS:

7. Project Manager / Key Personnel Name:

8. Contract No.:

9. Type of Contract:

[e.g., Firm Fixed Price, Cost-Reimbursement, Labor Hours, Hybrid, etc.]

10. Customer/entity for which contract is performed:

[e.g., government-BLM, commercial business, financial institution, etc.]

11. Contracting Officer (CO) name:

12. Contracting Officer Representative (COR) name:

13. Date of Award:

14. Completion Date:

15. Contract Percent Complete:

16. Contract Award Amount:

17. Total Modification Amount

18. Final Contract Amount:

19. Location of work:

20. Contract Description [Provide a detailed description of the contract/order requirements, including the services provided and specify the type of animals as well as the maximum number that was serviced per day. For IDIQ task order contracts, state the number of orders issued during the IDIQ contract performance period.]

BLOCK B: to be filled out by Reference: (The following information will assist in the analysis of the data. Thank you for your assistance and time to respond to this PPQ.)

1. Name of Evaluator

2. Company/Agency Name:

3. Address:

4. Phone Number:

5. Email Address:

6. Position held or Function in relation to the contract:

BLOCK C: Rating of performance on items No. 1 through 15. If the rating is unsatisfactory or not applicable, please provide additional information in the appropriate block 17, remarks section of this form.

Please circle the appropriate rating and provide any supporting information /comments for the following:

e.g., maintaining SAM.gov, responding to Contractor Performance Reporting System, or audits etc.

e.g., BLM’s Comprehensive Animal Welfare Program

e.g., Key Personnel, pasture forage, supplemental feed, etc.

16a Print Name:

16b Signature of Evaluator & Date:

Offerors shall complete RFP Attachment No. 12 Block A of the PPQ and include the partially completed form in Proposal Volume IIb. The Offeror shall also send the PPQ form (with Block A completed) to the designated reference/evaluator.

References are responsible for completing Blocks B and C and submitting the finalized PPQ directly to BLM via email at Cristina_hayden@ios.doi.gov.

Offerors are responsible for coordinating with references to ensure timely submission. If a completed PPQ is not received by the proposal deadline, BLM may independently contact the references identified in PPQ Block A of Volume IIb.

Completed PPQs (Blocks A–C) must be submitted directly by the reference or completed by BLM through direct contact with the reference. PPQs submitted directly by the Offeror (including completed Blocks B and C) will not be accepted.

The Government may verify PPQ information with listed points of contact or other sources. If information cannot be verified, it may be disregarded. The Government may review past performance from sources beyond those submitted by the Offeror. References may be current or former federal employees and must be familiar with the Offeror’s performance on relevant contracts.

Version 2, 6.29.2026