Attachment 2: Past Performance Questionnaire

Solicitation # HDTRA126R0085
Attachment _

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor:
Subcontract No. (if applicable):
POC:
(Name)

Contract No.:
Title:

(E.G. PCO/ACO/PM)

(Agency, Telephone No., E-mail Address & Fax Number)
The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.
Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory. Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:
Address:
Program Identification/Title:
Contract Number:

Solicitation # HDTRA126R0085
Attachment __

Contract Type:
Prime Contractor Name (if different from the contractor name cited above): Contract Award Date:
Forecasted or Actual Contract Completion Date: Nature of the Contractual Effort or Items Purchased:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:
Title:
Date:
Telephone Number:
Address:
E-mail Address:
PART II. EVALUATION (To be completed by Point of Contact – Respondent) A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship