Attachment 8: Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

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. Contractor Information

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

XXXXX

DUNS Number

XXXXXXX

Point of Contact
Name, Email, Phone

Contract Information

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. Satisfactory
Performance met contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. Marginal
Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. Unsatisfactory
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Evaluation Area
Rating
Quality

Quality of workmanship (including subconsultants)?
Choose an item.
Quality of and adherence to quality control plan?
Choose an item.
Quality of informational and technical submittals?
Choose an item.
Overall Quality Rating