7. ATTACHMENT 3 - PAST PERFORMANCE QUESTIONNAIRE.doc
DOC document 42 KB Posted
- Solicitation number
- HQ003421R0162
- Issued by
-
DOD Washington Headquarters Service
About this file
This document contains a past performance questionnaire template for a federal contractor evaluation. The questionnaire requests information on previous contracts including contract number, dates, value, type, description, quality of products and services delivered, performance, schedule adherence, customer satisfaction, and small business participation goals if applicable. Evaluators are asked to provide statements on these past performance factors for the contractor under consideration. The purpose is to collect data to support source selection for an upcoming solicitation to assess the transfer of dual-use technology from the Defense Advanced Research Projects Agency and defense laboratories.
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PAST PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a vendor evaluation for solicitation:
Please complete this Questionnaire and email to: Frederick.c.ray.civ@mail.mil
Email Subject Line:
Desired Response Date and Time:
When complete, the information on this form is SOURCE SELECTION INFORMATION (FAR 2.101 & 3.104) and shall be protected accordingly.
TO BE COMPLETED BY OFFEROR
| 1. CONTRACTOR NAME & ADDRESS: |
| 2. CONTRACT NO.: |
3. CONTRACT INITIATION DATE (Month/Year):
4. COMPLETION DATE (Month/Year):
5. CONTRACT VALUE (with options): $
1a: Name of Prime Contractor
6. TYPE OF CONTRACT:
(e.g., FFP, CPFF, T&M,)
7. BRIEF DESCRIPTION OF CONTRACT REQUIREMENTS:
Please add a continuation page if additional space necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
8. EVALUATION: a. EVALUATOR'S NAME, POSITION ( Project Manager/ COR/ Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
A. Quality of Products and Services – Please provide a statement regarding the contractor’s conformance (both for Prime and supporting team) to contract requirements, specifications, and standards of good workmanship (e.g., engineering/scientific technical expertise and innovativeness; professional workforce turnover to include key personnel and Subject Matter Experts; Program/Project Manager collaboration and communication with Government counterparts, etc.).
B. Performance – Please provide a statement regarding the Prime contractor’s technical contribution and performance for the project. Include any Prime contractor engineering development (e.g. Mission Engineering, Software Engineering, Systems Engineering & Development Test and Evaluation, Prototyping, Experimentation, Modeling and Simulation, Operations Research, Science and Technology (S&T) Research and assessment, Data Management and analysis, data management) in this project.
C. Schedule – Please provide a statement regarding the timeliness of Prime contractor against the schedule of deliverables.
D. Customer Satisfaction – Please provide a statement regarding the contractor’s responsiveness and adaptation to customer needs. Would you award to this contractor again based on your experience with them?
E. Small Business Participation Goals – Please provide extent that the contractor attained small business participation goals on this contract if applicable.
Section 7 Continuation Page
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