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
Street address, City, State
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
Description
Relevant
Past/present performance effort involved much of the similarity, magnitude of effort and complexities this solicitation requires. Somewhat
Relevant
Past/present performance effort involved some of the similarity, magnitude of effort and complexities this solicitation requires. Not
Relevant
Past/present performance effort did not involve any of the similarity, magnitude of effort and complexities this solicitation required.

Evaluation Area
Rating
Quality

Quality of workmanship (including subcontractor)?
Not Applicable
Quality of and adherence to quality control plan?
Choose an item.
Quality of informational and technical submittals?
Choose an item.
Overall Quality Rating
Choose an item.
Comments: Please provide comments supporting the above ratings.

Schedule (& Time Management)

Met project schedule milestones?
Choose an item.
Responded to owner requests in a timely manner?
Choose an item.
Informational and technical deliverables submitted timely? Choose an item.
Promptly addressed scheduling issues?
Choose an item.
Overall Schedule (& Time Management) Rating
Choose an item.
Comments: Please provide comments supporting the above ratings.

Cost / Price

Provided fair and reasonable pricing for contract awards and modifications? Choose an item.
Submitted accurate and complete invoices?
Choose an item.
Overall Cost /Price Rating