Attachment_5_Past_Performance_Questionnaire.pdf

Attachment 5 Past Performance Questionnaire

NOTE: Please refer to the RFQ clause entitled, Past Performance Information 1552.215-75 for specific instructions on how to complete and submit this questionnaire.

Name of Offeror: _______________ ____________________________________________________ Client/Contract Information (supplied by offeror)

Name of Client: _______________________________ Contract Number: ______________________

Contract Title: ________________________________ Contract Value: ________________________

Type of Contract: _______________________ Period of Performance: ________________________

The ratings below are supplied by the contractor identified above, NOT the offeror.

Performance Elements

Exceptional Very Good Satisfactory Marginal Unsatisfactory

1. Quality of product or service

2. Cost Control

3. Timeliness of performance

4. Business Relations

5. Remarks on outstanding performance:

Provide data supporting this observation; you may continue a separate sheet if needed.

6. Remarks on unsatisfactory performance:

Provide data supporting this observation; you may continue a separate sheet if needed.

7. Please identify any corporate affiliations with the offeror.

8. Other comments that you wish to make:

9. Would you do business with (insert offeror’s name) again?

10. Questionnaire completed by:

Name:

Title:

Mailing Address (Street and P.O. Box):

City, State and Zip Code:

Telephone Number:

Fax Number:

Attachment 5 Past Performance Questionnaire

Information Provided:

Ratings and Performance Categories

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated 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 contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

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 appear or were satisfactory.

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

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.

NOTE: Please refer to the RFQ clause entitled, Past Performance Information 1552.215-75 for specific instructions on how to complete and submit this questionnaire.