Past_Performance_Questionnaire.doc

CONTRACTOR PERFORMANCE REPORT

PRIVATE

CONTRACTOR PERFORMANCE REPORT –

[ ] Final or [ ] Interim – Period Report: From / / To / /

2. Contract Number:

Task Order Number:

3. Value:

4. Award Date:

Completion Date:

5. Type of Contract:(Check all that apply)-[ ]FP [ ]FP-EPA [ ]CPFF – Completion [ ]CPFF-Term [ ]CPIF

[x ]CPAF [ ]ID/IQ [ ]BOA [ ]Requirements [ ]Labor Hour [ ]T&M [ ]CR [ ]Other

6. Description of Requirement:

7. Ratings. After commenting, score, in column on the right, using 1 for unsatisfactory, 2 for marginal, 3 for satisfactory, 4 for very good, and 5 for exceptional.

Quality of Work – Comments

Customer Satisfaction – Comments

Business ethics/Behavior – Comments

Cost Control – Comments

Timeliness of Performance – Comments

Total Score (sum of scores from each area)

Mean Score (sum of scores divided by number of areas evaluated):

8. Subcontractors and Teaming and Joint Venture Partners

List major subcontractors, team, joint venture partners, by name with brief description of work and names of key personnel.

A.

B.

C.

Comments:

10. Would you select the firm again? Yes _ ___ No ____

Is/Was the contractor committed to customer satisfaction? Yes ____ No ____

Name completing questionnaire: _________________________________

Firm: _______________________________________ Phone number:__________________________

Release of Information: This Contractor Performance Report may be used to support future award decisions, and will be treated as source selection information in accordance with FAR 3.104-4(k)(1)(x) and 42.1503(b). The completed report shall not be released to other than Government personnel and the contractor whose performance is being evaluated during the period the information is being used to provide source selection information.