3. Past Performance Questionnaire.doc
DOC document 49 KB Posted
- Attached to
- ENVIRONMENTAL GROUNDWATER SAMPLING/INVESTIGATION Federal contract opportunity
- Solicitation number
- W911KF22Q0035
About this file
This document contains a past performance questionnaire and information regarding a forthcoming federal contract opportunity for environmental groundwater sampling and investigation services. The past performance questionnaire requests information about a contractor's prior work including contract details, description of requirements, and evaluations of quality, schedule, environmental compliance, and overall performance. The federal contract opportunity will be a service contract solicited by Anniston Army Depot for conducting semi-annual groundwater sampling, compiling monitoring reports, and conducting environmental release investigations as needed. The work will involve sampling groundwater wells, submitting samples to an EPA-certified lab meeting QA/QC requirements, and preparing sampling plans and annual reports. Optional tasks may include site investigations for spills or new waste sites. This is a 100% small business set-aside with an estimated issue date of July 13, 2022.
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Text version
Past Performance Questionnaire
This Questionnaire relates to a solicitation for _ (generic item description) ____.
PAST PERFORMANCE QUESTIONNAIRE –
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and e-mail or send by facsimile
Director of Contracting
Anniston Army Depot
7 Frankford Ave.
Anniston, AL 36201-4199
ATTN:
Desired Response Date:
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
| 1. CONTRACTOR NAME & ADDRESS: |
| 2. CONTRACT NO.: |
3. CONTRACT INITIATION DATE:
4. COMPLETION DATE:
5. CONTRACT VALUE (with options): $
6. TYPE OF CONTRACT:
7. DESCRIPTION OF CONTRACT REQUIREMENTS:
Please add a continuation page if additional space necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION: a. EVALUATOR'S NAME, POSITION ( Project Manager/ COR/ Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NUMBER:
c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic (A –J) that best reflects your experience with this contractor.
| EX = Exceptional |
| G = Good |
| P = Poor |
| N/O = Not Observed |
A. Quality – Assess how well contractor conformed to specifications and provided a quality product.
EX
G P N/O
B. Quality – Assess contractor’s ability to manage requirements, resolve technical and production problems, and adjust to changes.
P
C. Quality – Assess contractor’s availability and responsiveness to customer needs.
P N/O
D. Quality - Assess contractor’s performance in adherence to sound inspection and test processes
EX
G P
E. Schedule – Assess contractor’s adherence to schedule requirements, including accelerations and/or slippages in schedule.
P
F. Schedule – Assess contractor’s ability to gather and assimilate information and prepare for start-up in the initial stages of your project.
P
G. Schedule – Assess the contractor’s ability to manage its subcontractors.
P
H. Environmental Compliance – Assess contractor’s performance in adherence to environmental-related legal and regulatory requirements.
P N/O
I. Availability of Spare Parts – Assess contractor’s ability to manage parts requirements and ensure timely parts availability.
EX
G P
J. Overall Assessment -
P
Please provide a short narrative addressing the basis for the ratings assigned; address compliance with requirements, actual performance, problems encountered and problem resolution.
Use additional pages as needed.
A. Quality – Assess how well contractor conformed to specifications and provided a quality product:
B. Quality – Assess contractor’s ability to manage requirements, resolve technical and production problems, and adjust to changes:
C. Quality – Assess contractor’s availability and responsiveness to customer needs:
D. Quality - Assess contractor’s performance in adherence to sound inspection and test processes:
E. Schedule – Assess contractor’s adherence to schedule requirements, including accelerations and/or slippages in schedule:
F. Schedule – Assess contractor’s ability to gather and assimilate information and prepare for start-up in the initial stages of your project:
G. Schedule – Assess the contractor’s ability to manage its subcontractors:
H. Environmental Compliance – Assess contractor’s performance in adherence to environmental-related legal and regulatory requirements:
J. Overall Assessment:
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