A3 - Past Performance.pdf
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- Solicitation number
- N4002725R3000
About this file
This is a Past Performance Questionnaire template used for federal contract source selection evaluation. The form is completed by customer references (not the offeror) and submitted directly to government points of contact to assess a contractor's performance on previous contracts.
The questionnaire collects reference contract information including the entity providing the reference, contractor name, contract number, dollar value, phone number, period of performance, contract type, and service description. References are rated on seven performance elements: Quality of Service, Timeliness of Performance, Effectiveness of Management, Initiative in Meeting Requirements, Responsiveness to Performance Problems, Customer Satisfaction, and Overall Performance. Ratings use a six-point scale (N/A, 5-Exceptional, 4-Very Good, 3-Satisfactory, 2-Marginal, 1-Unsatisfactory) with detailed descriptors for each level. The form requires narrative remarks on exceptional performance and unsatisfactory or below-performance areas, identification of corporate affiliations with the offeror, and a response to whether the reference would do business with the contractor again. Completed questionnaires must be submitted by 15 June 2026 at 1000 EST via email to the SERMC Contracting Office points of contact: Logan Barrett (logan.d.barrett3.civ@us.navy.mil) and Safire Pena (safire.m.pena.civ@us.navy.mil).
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ATTACHMENT 3
SOURCE SELECTION SENSITIVE INFORMATION
PAST PERFORMANCE QUESTIONNAIRE
Past Performance Reference Contract Information
Name of Entity Providing Reference: ----------------------- Contract Number: ---------------------------
Contractor Name: --------------------------------------- Contract Dollar Value: -----------------------
Contract Title: ------------------------------------------ Phone Number: -----------------------------
Reference POC: ----------------------------------------- Period of Performance: ----------------------
Type of Contract: ----------------------------------------
Description of Service:
The ratings below shall be supplied by the offeror' s customer reference identified above. The questionnaire form shall be submitted by the customer directly to the Government POCs identified below, NOT the offeror.
NIA - Not Applicable
5 - Exceptional- Performance meets contractual requirements and exceeds many to the Government' s benefit. For example, the contractor implemented innovative or business process reengineering techniques, which resulted in added value to the Government/Industry. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
4 - Very Good- Performance meets contractual requirements and exceeds some to the Government' s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
3 - Satisfactory- Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
2 - Marginal- Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor' s proposed actions appear only marginally effective or were not fully implemented.
1 - Unsatisfactory- Performance does not meet most contractual requirements and recovery is not likely in a timely manner.
The contractual performance of the element or sub-element contains serious problem(s) for which the contractor' s corrective actions appear or were ineffective.
Performance Elements NIA 5 4 3 2 1
1 . Quality of Service
2. Timeliness of Performance
3 . Effectiveness of Management
4. Initiative in Meeting Requirements
5 . Responsiveness to Performance Problems
6. Customer Satisfaction
7. Overall Performance
Remarks on exceptional performance:
Remarks on unsatisfactory or below performance:
Please identify any corporate affiliations with the offeror.
Would you do business with this company again?
Please submit this Questionnaire no later than 15 JUN 2026, 1 000 EST via e mail to the SERMC Contracting Office POC Logan Barrett at logan.d.barrett3.civ@us.navy.mil and Safire Pena at safire.m.pena.civ@us.navy.mil
File details come from the government source that posted it. Updated .