Attachment 3- Past Performance Questionnaire.pdf

ATTACHMENT 3: PAST PERFORMACE

QUESTIONNAIRE SOLICITATION # 1305M324Q0240

Source Selection Information

PAST PERFORMANCE QUESTIONNAIRE

Contractor Being Evaluated:

Contract number:

Project Title:

Period of Performance:

Total Funded Value:

Past Performance Reference Name:

Reference role on the project:

Questionnaire Instructions: Please assess the contractor’s performance on the referenced contract using the following adjectival rating scale:

ADJECTIVAL

RATING

DEFINITION

EXCEPTIONAL

Performance meets contractual requirements and exceeds many to the Government’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 meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

SATISFACTORY

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor appear or were satisfactory.

MARGINAL

Performance does 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.

Source Selection Information

1. QUALITY OF SERVICE. Assess the contractor’s performance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, or environmental standards).

Rating:

Comments:

2. SCHEDULE. Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or affect the schedule variance.

Rating:

Comments:

3. COST CONTROL. Assess the contractor’s effectiveness in forecasting, managing, and controlling cost.

Rating:

Comments:

5. MANAGEMENT. Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior, and customer satisfaction. Check the appropriate rating box.

Rating:

Comments:

Source Selection Information

Given what I know today about the contractor's ability to perform in accordance with this contract or order's most significant requirements, I ___would ___would not recommend them for similar requirements in the future.

ADDITIONAL COMMENTS, IF ANY:

PAST PERFORMANCE REFERENCE SIGNATURE [note: digital signature is acceptable]: