47QMCB24Q0004_Attachment B_Past_Performance_Questionnaire.pdf

ATTACHMENT B

PAST AND PRESENT PERFORMANCE INFORMATION/QUESTIONNAIRE

A. Offeror Information

Contractor’s Name:

Telephone Number:

Address:

Email:

Point of Contact:

B. Project Title and Brief Description

C. Contract Data

Contract Number: Delivery/Task Order Nr:

Point of Contact Name: Title:

Phone Number: Email:

Contract Type:

Contract Dollar Value: (Base Year $ ) ($ , Total of all options)

Contract Period of Performance: (base + all option periods)

Contractor performed as the □ Prime Contractor □ Sub-Contractor □ Key Personnel.

A. Reference/Respondent Information

Contract Number:

Total Contract Value: $

Period of Performance

Name of Respondent:

Title:

Organization Name:

Telephone Number:

Email Address:

Please identify any information known to be inaccurate as provided by the Offeror in Part I.

B. Email completed questionnaire form to: elizabeth.m.mcewen@gsa.gov with a CC to onthego@gsa.gov

PART I: REFERENCE INFORMATION (Offeror to complete this part and return with Past

Performance information in accordance with instructions provided in the solicitation.)

PART II: RESPONDENT INFORMATION (To be completed by Reference Point of Contact)

Solicitation Number: 47QMCB24Q004 Attachment B: Past Performance Questionnaire mailto:katherine.cartoski@gsa.gov%09

C. PERFORMANCE INFORMATION: Using the adjectival rating table below, choose the appropriate letter in the attached Questionnaire (i.e., E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation.

ADJECTIVAL RATING DEFINITION

E Exceptional

Performance meets contractual requirements with many exceeded to the firm’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

G Very Good

Performance meets contractual requirements with some exceeded to the firm’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

S Satisfactory

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

M Marginal

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented

U Unsatisfactory

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective

N/A Not Applicable Performance was not observed or not applicable to the current effort being reported against

Solicitation Number: 47QMCB24Q004 Attachment B: Past Performance Questionnaire

CURRENT/PAST PERFORMANCE QUESTIONNAIRE

Contractor’s Name: Contract Number:

Place an “X” in the appropriate column using the definitions matrix above:

Assess the following areas:

Assessment Categories Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A

Quality of Product/Service

Schedule

Cost Control

Business Relations

Management of Key Personnel

Reliability

Customer Support

Overall Performance

Other Areas [identify]

Additional Comments:

Solicitation Number: 47QMCB24Q004 Attachment B: Past Performance Questionnaire