ATTACHMENT_4_-_Past_Performance_Survey.pdf

PAST PERFORMANCE SURVEY

This past performance survey is to be completed on the designated contractor or key personnel as designated below:

PAST PERFORMANCE PROJECT IDENTIFICATON (To be filled out by the Offeror):

CONTRACTOR OR KEY PERSONNEL

NAME:

Click here to enter text.

CONTRACT or ORDER NUMBER: Click here to enter text.

PROJECT TITLE: Click here to enter text.

TOTAL PERIOD OF PERFORMANCE,

INCLUDING OPTIONS

Click here to enter text.

PAST PERFORMANCE REFERENCE INFORMATION (To be filled out by the Reference):

NAME: Click here to enter text.

TITLE: Click here to enter text.

AGENCY or CUSTOMER: Click here to enter text.

PHONE: Click here to enter text.

E-MAIL Click here to enter text.

The Department of Housing and Urban Development (HUD) is procuring the services described in the box below.

You have been selected by the contractor or key personnel identified above to provide past performance information to HUD to be used in evaluating the offeror’s proposal for this acquisition. Thank you for your input.

Summarize the services acquired here.

If this past performance survey is related to key personnel, please summarize the level of interface you had with the designated key personnel throughout the life of the project you oversaw.

For each of the Five (5) criteria listed below, the rater must choose One (1) Adjectival Rating by checking the box, as applicable. At a minimum, for any rating that is checked Exceptional, Very Good, Marginal or Unsatisfactory, please submit additional comments to substantiate the rating. If Cost Control is N/A, Please explain why.

1. QUALITY OF SERVICE

RATING Adjectival Rating

Definition

Exceptional

Performance meets contractual requirements and exceeds many to the Government’s benefit.

The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Very Good

Performance meets contractual requirements and exceeds some to the Government’s benefit.

The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Satisfactory

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Marginal

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Unsatisfactory

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

ADDITIONAL COMMENTS:

2. SCHEDULE

3. COST CONTROL

Not Applicable

4. BUSINESS RELATIONS

5. MANAGEMENT OF KEY PERSONNEL