Past Performance Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

Solicitation 6FLS-K2-090407-N Please complete this Questionnaire and e-mail or fax to Contract Specialist, Margaret Conroy

E-mail: margaret.conroy@gsa.gov FAX: 816-926-3678.

We are currently in the process of preparing our proposal for the General Services Administration, FAS, Solicitation Number 6FLS-K2-090407-N, FSC 8010 Miscellaneous Items. As part of our proposal, we have listed you as a reference on our performance for this type of product with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail or fax to Contract Specialist, e-mail margaret.conroy@gsa.gov FAX: 816-926-3678.

Questionnaire is due to Margaret Conroy no later than 2:00 PM Central Daylight Time on February 12, 2010. Questionnaire must be submitted directly to the Contract Specialist on company letterhead if faxed or emailed from a corporate email account.

If you will not be available on February 12 or 17, 2010 for verification of this past performance evaluation please indicate another POC for the contacting officer to contact.

Alternate POC name: ________________________________________

Alternate POC phone number: _________________________________

Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR:

Phone:

Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance: ________________________________________________________ ______________________________________________________________________________

4. Brief description of items provided: _______________________________________________

5. Name of Person Completing Questionnaire: _______________________________________ Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________ II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions – The following definitions should be used in the assessment of Contractor performance.

Past Performance Evaluation

Question 1. Performance What is your assessment of the Contractor’s ability to meet your requirements?

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products in a timely manner?

Timeliness

Ability to Resolve Timeliness Problems

Question 4. Quality of Shipments What is your assessment of the Contractor’s ability to meet requirements of shipping (including packing, marking, etc) and the overall quality of the delivery?

Quality of Shipments

Question 5. Overall Rating of Contractor’s performance What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

General Comments:

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