Attachment 2: Past Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name:

Telephone Number:

Address:

Fax Number:
Point of Contact:

Project Title and Brief Description of Work:

Contract Number Provided by Offeror:

*

Dollar Amount:

Contract Period or Dates of Performance Provided by Offeror: Contractor performed as the  Prime Contractor  Sub-Contractor  Key Personnel.

*

*

B. RESPONDENT INFORMATION:

Name of Respondent:
Address:

Title:
Telephone Number:
Fax Number:
Email Address:

C. E-MAIL/FAX COMPLETED SURVEY FORM TO: Requesting Firm

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (A, U, N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS of U.

A

U

N

Acceptable

Unacceptable

Neutral

Based on the offeror’s performance
record, the offeror will successfully
perform the required effort

Based on the offeror’s performance
record, the offeror will be able to
successfully perform the required
effort.

Performance was not observed
or not applicable to the current
effort being reported against.

CONTRACTOR’S NAME:

CONTRACT NUMBER:

.
Place an “X” in the appropriate column using the definitions matrix above.

The contractor:
1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet
contract requirements.
2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. 3. Delegated authority to project managers and supervisors commensurate with contract requirements.
4. Home office participated in solving significant local problems.
5. Followed approved quality control plan.
6. Provided effective quality control and/or inspection procedures to meet contract requirements.
7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.
8. Provided timely resolution of contract discrepancies. 9. Identified problems as they occurred.
10. Suggested alternative approaches to problems.
11. Displayed initiative to solve problems.
12. Staffing plans, service schedules, response times

13. Service schedules, response times

A

U

N

The contractor:
14. Urgent service requests and corrective actions
15. Was responsive to contract changes.
16. Provided adequate project supervision.
17. Personnel qualifications, training, safety, and security