Attachment_B_Past_Performance_Questionnaire.docx

Attachment B. Past Performance Questionnaire

Name of Offeror ________________________ SECTION #7 – Past Performance

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Phase I Solicitation 13-102-SOL-00001

Section 1: To Be Completed by the Offeror

Project Title:

Total Project Price/Cost:

Period of Performance:

Date of Completion:

Project Description:

Section 2: To Be Completed by the Owner/Customer

Name and Title of Evaluator

Evaluator Contact Information (Phone Number, Email):

Overall Performance of the Contractor (Choose One):

Excellent Good Satisfactory Marginal Unsatisfactory

Please provide a short narrative regarding the Offeror’s performance on this project:

1. What aspects of the project did the Offeror perform well?

2. What aspects of the project were problematic for the Offeror?

3. Would you utilize this Offeror again and why?

The Evaluator is directed to submit this completed past performance questionnaire directly to IHS via email to Contract Specialist Jane.Stuessy@ihs.gov no later than February XX, 2013. If you have questions, Ms. Stuessy can be reached at 206-615-2533.