Attachment_4-Past_Performance_Questionnaire_0001.pdf

ATTACHMENT 4:

PAST PERFORMANCE

QUESTIONNAIRE

SOLICITATION

Source Selection Information

PAST PERFORMANCE QUESTIONNAIRE

CONTRACTOR BEING REVIEWED:

PERSON COMPLETING QUESTIONNAIRE:

REFERENCE CONTRACT #:

BRIEF DESCRIPTION:

Send Completed Questionnaire to at no later than

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).

(Check the appropriate rating box.)

RATING 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.

Comments:

Source Selection Information

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).

(Check the appropriate rating box.)

RATING 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

3. COST CONTROL

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

(Check the appropriate rating box.)

RATING 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

4. 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 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

ADDITIONAL COMMENTS, IF ANY:

Rater’s Name: ___________________________

Rater’s Signature: ________________________

Rater's Email Address______________________

Rater's Phone #___________________________

Date: ____________________________________