J-05 Performance Assessment Questionnaire.pdf

FOR OFFICIAL USE ONLY/ SOURCE SELECTION INFORMATION – SEE FAR 2.101, 3.104 AND 42.15

CONTRACTOR PERFORMANCE ASSESSMENT QUESTIONNAIRE

NAME/ADDRESS OF CONTRACTOR

Company Name:

Division Name:

Street Address:

City: State/Province:

Zip Code: Country:

CAGE Code: Unique Entity ID: PSC: NAICS Code:

Contract Percent Complete: Contract Number:

Business Sector: Sub-Sector:

Contracting Office:

Contracting Officer: Phone Number:

Location of Work:

Award Date: Effective Date:

Completion Date: Estimated/Actual Completion Date:

Total Dollar Value: Current Contract Dollar Value:

Complexity: Contract Type:

KEY SUBCONTRACTOR(S) AND EFFORT PERFORMED

Key Subcontractor(s):

Unique Entity ID:

Effort Performed:

Project Title:

Contract Effort Description:

Small Business Utilization:

• Does this contract include a subcontracting plan?

• Date of last Individual Subcontracting Report/Summary Subcontracting Report:

Variance (Contract-to-Date):

EVALUATION AREAS

Quality:

Schedule:

Cost Control:

Management:

Utilization of Small Business:

Regulatory Compliance:

ASSESSING OFFICIAL COMMENTS

Quality:

Schedule:

Cost Control:

Management:

Management Responsiveness:

Subcontract Management:

Program Management and Other Management:

Management of Key Personnel:

Utilization of Small Business:

Regulatory Compliance:

RECOMMENDATION:

Given what I know today about the contractor’s ability to perform in accordance with this contract or order’s most significant requirements, I recommend them for similar requirements in the future.

NAME AND TITLE OF ASSESSING OFFICIAL

Name: Title:

Organization: Phone Number:

Email Address: Date: