Attachment - Past Performance Survey (Fillable).doc
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- Solicitation number
- 1131PL26R0049
About this file
This is a Past Performance Survey template designed for the Indo-Pacific Digital Infrastructure Project Scoping Services solicitation (1131PL25R0049) issued by the United States Trade and Development Agency (USTDA). The fillable form is submitted to USTDA's Office of Acquisition Management at Contractproposals@ustda.gov with a deadline of 1:00 PM, July 22, 2026 (Arlington, VA time). The survey must be completed by the reviewer and contains fields for contractor identification, contract reference information, period of performance, contract value, and brief service descriptions.
The survey consists of six questions designed to assess contractor performance across key dimensions: compliance with contract terms and conditions, schedule performance, requirement fulfillment, corrective action capabilities, and future business recommendation. Each question includes a five-point confidence scale (Substantial, Satisfactory, Limited, Unknown/Neutral, or No Confidence). Questions 5 and 6 allow for narrative comments regarding future business recommendations and any additional performance observations. The template is intended to gather qualitative feedback on contractors' past performance for evaluation purposes in the competitive solicitation process.
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Text version
Solicitation No.: 1131PL25R0049 Solicitation Indo-Pacific Digital Infrastructure Project Scoping Services
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 22, 2026, Arlington, VA Time. Survey must be submitted by the reviewer.
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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