Attachment I - Past Performance Survey (Fillable).doc
DOC document 44 KB Posted
- Solicitation number
- 1131PL24RDS11193
About this file
This document is a Past Performance Survey for a federal contract opportunity. The survey is seeking feedback on the performance of a contractor under a previous contract with information such as the contractor's ability to comply with contract terms, complete work on schedule, and take corrective measures. The key details of the related federal contract opportunity are:
The solicitation is for a Regional Sub-Saharan Africa: Desk Study for Sub-Saharan Africa Healthcare Infrastructure Sector Opportunities, with Solicitation Number 1131PL24RDS11193. It is being issued by the United States Trade and Development Agency under FAR Part 15. The award will be made to the responsible offeror that provides the best value to the government. The procurement is unrestricted under NAICS Code 541690 (Other Scientific and Technical Consulting Services). Award is limited to U.S. firms or U.S. individuals, and contractor and subcontractor employees must be U.S. citizens or lawfully admitted permanent residents. Subcontractor use is limited to less than 50% of the proposed price. Proposals are due by 1:00 PM on July 26, 2024.
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Text version
SOLICITION NUMBER: 1131PL24RDS11193
TITLE: REGIONAL AFRICA – HEALTHCARE INFRASTRUCTURE SECTOR OPPORTUNITIES DESK STUDY SERIES
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, July 26, 2024, Arlington, VA Time.
Name of Contractor Being Reviewed:
Contract Number/Reference Information:
Name of Agency/Organization Submitting Review for this Contractor:
| Name of Person Completing Questionnaire |
| Phone Number |
| Email Address |
| Period of Performance: XX/XX/XXXX – XX/XX/XXXX |
| Brief Description of Services: XXXXXXXXX |
Total Contract Value: $XXXX.XX
Contract Performance Information
| Questions: |
| Response: |
| 1. How would you rate your confidence in the contractor’s ability to comply with contract terms and conditions? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 2. How would you rate your confidence in the contractor’s ability to complete work on schedule? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 3. How would you rate your confidence in the contractor’s ability to comply with the actual requirements? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 4. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
5. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.
· Yes
· No
Comment:
| 6. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss? |
| · Yes |
· No Comment:
USTDA sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.
Additional Comments:
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