Attachment D - Past Performance Questionnaire

ATTACHMENT C: PAST PERFORMANCE QUESTIONNAIRE

Instructions:
The Bureau of Engraving and Printing (BEP) requests recent past performance. Recent is defined as five (5) years from the date of Request for Quotation (RFQ) issuance. Offeror shall send the questionnaire to at least two (2) Assessors (personnel or organization) for which services were provided. Services must be relevant to BEP’s requirement. Relevant is defined as similar in size, scope, and complexity to the BEP’s requirement identified in the Performance Work Statement. Offeror shall complete Section II prior to submitting the questionnaire to Assessor(s). The Assessor(s) shall validate/confirm Section II information and complete Sections III and V. The Assessor(s), NOT THE OFFEROR, shall email the completed questionnaire to the contracting office point of contact no later than the date and time indicated below. Message to the Assessor: Your assistance is requested by the BEP to assist with establishing the performance history for the Contractor named below. Please validate/confirm Section II information, complete Sections III and V, and sign the questionnaire. Completed questionnaire shall be emailed to [email protected] no later than 12:00 PM Eastern, on Tuesday, 15 September 2026.

I. Solicitation Data (for the proposed effort)

Solicitation Number
2031ZA26R00023
Project/Requirement
Wastewater Pretreatment Plant in Washington, DC

II. Current or Historical Contract Information
Assessor: The performance data submitted by the Offeror is FORMCHECKBOX FILLIN \* MERGEFORMAT correct or FORMCHECKBOX incorrect.

CONTRACTOR NAME & ADDRESS:

Contract No

Type of Contract

Initial
Final

Contract Value

Period of Performance/Delivery Schedule

Project/Requirement Description

Please select from the following as it applies to this contract:

Contracting Role

FORMCHECKBOX PRIME

FORMCHECKBOX SUBCONTRACTOR

Termination History
FORMCHECKBOX Convenience
FORMCHECKBOX Default

FORMCHECKBOX N/A

III. Assessor Information

Assessor Name

Title

Phone Number/Email Address

Identify your role in the contract award or administration and the period of your involvement.

Role
Period of Involvement

Procuring Contracting Officer (PCO)

Administrative Contracting Officer (ACO)

Contract Specialist

Contracting Officer’s Representative (COR)

Technical Project Lead/Project Manager

Quality Assurance Specialist

Defense Contract Audit Agency (DCAA) Auditor

Other:

IV. Evaluation Definitions

The following definitions should be used in your assessment of Contractor performance.