Attachment_6_Past_Performance_Questionaire.docx
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ATTACHMENT 6
Please fax completed questionnaire to the Attention of Andrew J Thompson, Contracting, (601) 965-1788
PRESENT/PAST PERFORMANCE QUESTIONNAIRE
SECTION A: CONTRACTOR INFORMATION
A. Contractor’s Name and Address: ___________________________________________________
B. Point of Contact: _________________________________________________________________
C. Phone #: _______________________________________________________________________
D. Contract Number: _____________________ Contract Type: ____________________________
E. Project Title: ____________________________________________________________________
F. Period of Performance: ____________________________________________________________
G. Brief Description/Scope of Services provided: _________________________________________
H. Authorization is hereby granted to provide the information requested in SECTION B of this questionnaire.
Signature of Authorized Contractor Representative Date
Printed Name and Title of Authorized Contractor Representative
RESPONDENT INFORMATION:
A. Name:_________________________________________________________ B. Position:_______________________________________________________ C. Telephone Number:_____________________ Fax Number: ______________ D. Address:________________________________________________________ E. Relationship and Time Involved with Contractor:_______________________ F. Date Questionnaire Completed:_____________________________________
SECTION B OF ATTACHMENT 6
| E |
| VG |
| S |
| N |
| M |
| U |
| Excellent |
| Very Good |
| Satisfactory |
| Neutral |
| Marginal |
| Unsatisfactory |
CONTRACT PERFORMANCE
| 1. |
| Working relationship with your Company |
| E |
| VG |
| S |
| N |
| M |
| U |
| 2. |
| Did the contractor provide experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements? If no, please explain. |
| Yes |
No
N/A
| 3. |
| Did Contractor comply with contract specifications? If no, please explain. |
| E |
| VG |
| S |
| N |
| M |
| U |
| 4. |
| Did the contractor properly use and provide the proper equipment for use by its personnel? If no, please explain. |
| Yes |
No
N/A
| 5. |
| Did the contractor demonstrate the ability to hire, train, maintain, and replace, if necessary qualified personnel during the contract? If no, please explain. |
| Yes |
No
N/A
| 6. |
| Does the contractor provide the proper equipment for personnel to provide timely and accurate records? Did they provide timely and accurate records? If no, please explain. |
| Yes |
No
N/A
| 7. |
| Did the contractor perform the necessary drug testing and background checks? If no, please explain. |
| E |
| VG |
| S |
| N |
| M |
| U |
| 8. |
| Would you award similar contracts to this contractor (If no, Please explain in remarks) |
| Yes |
No
N/A
| 9. |
| Contractor’s Overall Performance |
| E |
| VG |
| S |
| N |
| M |
| U |
QUALITY OF SERVICE/CONTROL
| 1. |
| Contractor’s accomplishment in meeting the quality standards |
| E |
| VG |
| S |
| N |
| M |
| U |
| 2. |
| Did the contractor provide an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain. |
| Yes |
No
N/A
| 3. |
| Were there any issues with the contractor’s oversight or quality control? If yes, please explain. |
| Yes |
No
N/A
| 4. |
| Overall Quality of Service/Control |
| E |
| VG |
| S |
| N |
| M |
| U |
TIMELINESS OF PERFORMANCE
| 1. |
| Did contractor meet dates or milestone specified in contract or agreed to in project schedule? If not, explain |
| Yes |
No
N/A
| 2. |
| Did contractor complete contract in a timely manner? |
| Yes |
No
N/A
REMARKS: If additional remarks are necessary, please attach an additional sheet.
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