Attachment 9: PastPerf Vol I

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NO. 140P2026R0106

INSTRUCTIONS: Offeror to complete Sections A and B and transmit questionnaire to reference. Reference to complete Sections C and D and transmit back to Contracting Officer listed in section E. Notice to Contractor
Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise. This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services. The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.

OFFEROR Information

Company Name
Company
Street Address
Address
City
City
State
State
Zip Code

XXXXX

Unique Entity Identifier (UEI) Number / SAM

XXXXXXX

Point of Contact
Name, Email, Phone

Contract Information FOR PAST PROJECT (PROJECT submitted uNDER PROJECT EXPERIENCE)

Project Title
Title
Contract Number

XXXXXXXXXX

Contract Type
Firm Fixed Price / Time & Materials / Cost Reimbursable / Other Awarded Contract Price

$X,XXX,XXX

Current / Final Price

$X,XXX,XXX

Contract Award Date

XX/XX/XXXX

Contract Completion Date

XX/XX/XXXX

Period of Performance

XX/XX/XXX – XX/XX/XXX

Project Location
Park or Street address, City, State
Client / Owner
Company
Brief description of the contract & work effort:
Scope of work description

Reference:

Name
First, Last
Position / Title
Title
Organization
Agency or Company
Phone Number

XXX-XXX-XXXX

Email Address
Email
Signature
Signature
Date

XX/XX/XXXX

Evaluation

Rating
Definition
Exceptional
Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. Very Good
Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.