Attachment_6_Past_Performance_Questionnaire.pdf

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Facility Hazardous Waste Removal and Emergency Response Services for the U. S. EPA
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RFQ-PA-13-00016
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Attachment 6 Past Performance Questionnaire

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Attachment 6: Past Performance Questionnaire

Name of Offeror: ___________________________________________________________

Name of the Reference: _____________________________________________________

Contract Title: _________________ Contract Value: ____________________

Contract Type: ___________________________ Period of Performance: ______________

Award Date: ______________________________

The purpose of this questionnaire is to obtain information regarding the quality of the above named Contractor’s past performance relative to a contract, completed or in progress, at your company/agency.

Performance Element Highly

Acceptable Acceptable Unacceptable

1. Contractor’s business relations

2. Cost control

3. Timeliness of performance

4. Understanding of tasks associated with packing/removal of hazardous waste

5. Preparation of manifests

6. Lab pack service overall

7. Training/Experience of technicians performing lab packing

8. Overall customer service

9. Receipt of certificates of disposal or treatment in a timely matter

10. Overall contractor performance in removal of hazardous waste

11. Ability in preparing waste stream profiles

RFQ-PA-13-00016 Attachment 6 - Past Performance Questionnaire Page 1 of 2

12. Would you use this contractor again in the future for similar services? Yes/No and Why/Why Not

13. Remarks on highly acceptable performance: Supporting observations

14. Remarks in unacceptable performance: Supporting observations

Additional Comments:

Please email completed questionnaire to gillespie.tiffany@epa.gov or FAX to 215/ 814-5211.

If you have any questions, please call 215/814-5308 and thank you for taking the time to provide this reference information. Also, please provide the information below in case we need to contact you to clarify a response.

Name/Position/Organization: __________________________________________________

Telephone No: _________________________ Email: _____________________________

RFQ-PA-13-00016 Attachment 6 - Past Performance Questionnaire Page 2 of 2 mailto:gillespie.tiffany@epa.gov

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