Section D.3 Past Performance Questionnaire.pdf

Space Planning IDIQ PBS- REG. 5 RFQ 47PF0024Q0033 Page 1 of 3

Past Performance Questionnaire

Contract Identification:

Contractor Name:

Contract Number and/or Project Name:

Dates of Performance:

Building Name, Address, City, and State of space serviced:

Relevant Criteria: Yes or No

_______1. The contract was for office space planning, interior design services, or furniture design services for a commercial or government owned space that involved at least 5,000 sq. ft.

________ 2. If completed, the contract was completed within the past five years?

________ 3. If current, the contract is at least 90% complete?

4. The offeror cannot use the same reference/contact person or project more than once.

Description of the Work Performed (include square footage involved):

Respondent (Reference) Identification:

Name and Title: _______________________________________________________________

Agency/Company: _____________________________________________________________

Address:_____________________________________________________________________

Telephone: __________________________________________________________________

The questionnaire and attached survey must be completed by the respondent identified above and emailed to GSA Contracting Officer at Timothy.novak@gsa.gov on or before the due date/time for submission of Phase I factors.

The relevant past performance references will be evaluated with an adjectival rating, which in turn will be translated into a numerical score, as indicated in the survey. The ratings will then be averaged for a composite score.

Excellent Very Good Satisfactory Marginal Unsatisfactory N/A or No Response mailto:Timothy.novak@gsa.gov

Space Planning IDIQ PBS- REG. 5 RFQ 47PF0024Q0033 Page 2 of 3

5 4 3 2 1 0

Past Performance Survey

Please check the level of the Contractor’s overall performance in each of the business management factors listed as it pertains to the referenced project. Check “N/A” if the factor does not apply to the contract being rated. Please fill out in its entirety.

*Please comment on all Marginal and Unsatisfactory ratings given (or on any other ratings, if desired).

Were any significant problems encountered and if so how well were they addressed?__________________________________________________________________________

Would you hire this contractor again? Yes (5) or No (0)

Do you have any additional comments either negative or positive concerning the contractor’s performance under your contract?

Evaluation Factor Performance Level Excellent Very

Good Satisfactory Marginal

Unsatisfactory

No Response (N/A)

1. Quality of deliverables

2. Project coordination

3. Communicating with customer including responsiveness and level of cooperation

4. Timely completion

5. Resolution of follow-up items

6. Overall performance on the contract

Space Planning IDIQ PBS- REG. 5 RFQ 47PF0024Q0033 Page 3 of 3

SAMPLE LETTER

Date

(Reference Name) (Reference Company Name) (Address) (City, State, and Zip Code)

RE: Reference for Past Performance RFQ 47PF0024Q0033

Dear (Name):

We are preparing an offer for the referenced RFQ. The RFQ requires submission of the attached Past Performance Questionnaire/Survey. In accordance with the instructions, the questionnaire should be filled out and emailed to: Timothy Novak, GSA Contracting Officer, at timothy.novak@gsa.gov.

Please note that GSA prohibits the release of the name of persons providing references or the information provided therein. Complete confidentially will be maintained.

Please complete the questionnaire/survey and email it to ensure it is received by the GSA Contracting Officer on or before the due date of Phase I factors, April 19, 2024 4:00 PM Central Time.

Sincerely, Sign <Insert Contractor Point of Contact> <Insert Contractor Name>