Attachment 3: Past Performance Questionnaire

ATTACHMENT NO. 3

FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)

SOLICITATION NUMBER 70FB8027Q00000003

PAST PERFORMANCE QUESTIONNAIRE

PROJECT TITLE: TRANSPORTABLE TEMPORARY HOUSING UNIT (TTHU) RETRO FIT

SHOWER AND ACCESSORIES INSTALLATION KITS

OCTOBER 22, 2026

Offerors were asked to provide information on for relevant work that has started within the past 3-years from date of issuance of the synopsis for this requirement. An Offeror submitted you as a reference for past performance. We need your opinion on how well the contractor performed on this contract. Please fill out this past due date of November 13, 2026 10:00 AM (EST).
Your input will be confidential. Please note your comments will be used to form the basis for evaluation of this offeror. Thank you in advance for your assistance.

CERTIFICATION

By law, the Government will not disclose the names of individuals providing reference information during discussions with the contractor identified in Block 1 below.

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FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)

PAST PERFORMANCE QUESTIONNAIRE

PROJECT TITLE: PTS

Block 1. Contractor/Reference & Period of Performance|
Block 2. Contract Number/Task Order Number (if applicable) (being rated) |

I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS QUESTIONNAIRE IS

ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Evaluator’s Printed Name
Title
Evaluator’s Mailing Address (Agency, Bldg/Room, Street, City, State, and Zip) Evaluator’s Signature Date
Phone

email

INSTRUCTIONS

Two forms are provided to document your opinion: 1) Performance Rating Form; and 2) Supplemental Comment Form. Please fill out each form in accordance with the instructions provided on each. Please use the following standards in arriving at your rating:
Exceptional - Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective Very Good - Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective. Satisfactory – Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor