Attachment 1: Past Performance Questionnaire

Attachment 1
Past Performance Questionnaire

Past Performance Questionnaire

ORGANIZATION’S PERFORMANCE QUESTIONNAIRE

Offerors shall submit this completed questionnaire as part of the proposal to the Contracting Officer, Troy White ([email protected]) and Contract Specialist, Michaela Farmer ([email protected]).

U.S. Government Publishing Office
Acquisition Services
732 North Capitol Street, NW
Room A530, Stop: AS
Washington, DC 20401

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY CONTRACTOR

1. CONTRACTOR’S NAME AND 3. CONTRACT NO.:

ADDRESS

CONTRACT DATE:

4. PERIOD OF PERFORMANCE:

4. PLACE OF PERFORMANCE:

5. COMPLETION DATE:

6. CONTRACT VALUE $

2. PROJECT NAME:

7. TYPE OF CONTRACT:

8. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:

Please add a continuation page if additional space is necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

9. NAME AND ADDRESS OF EVALUATING ORGANIZATION:

EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other)

Attachment 1
Past Performance Questionnaire

EVALUATOR’S PHONE NUMBER

MONTHS

PERFORMANCE

EVALUATOR:

MONITORED

BY

Please check the response code for each topic that best reflects your experience with this Contractor: EX = Exceptional
VG = Very Good
S = Satisfactory
MG = Marginal
= Unsatisfactory
N/O = Not Observed
Quality of Products and Services- Assess the Contractor’s conformance to contract requirements. EX
VG
S
MG
US
Overall Performance- Assess the Contractor’s overall performance for the project.

US

N/O

EX
VG
S
MG
US
N/O
Schedule- Assess the timeliness of the Contractor against the schedule of activities (as appropriate). EX
VG
S
MG
US
N/O
Technical Requirements- Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.
EX
VG
S
MG
US
N/O
Cost Control- Assess the Contractor’s willingness and ability to manage the contract budget and control costs.
EX
VG
S
MG
US
Subcontracting- Assess the Contractor’s success at complying with subcontracting goals.

N/O

EX
VG
S
MG
US
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
EX
VG
S
MG
US
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.