Att. 4 Past Performance Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

Performance Questionnaire

This questionnaire is provided to assist the Government in the past performance evaluation of offerors pertaining to a competitive acquisition that will result in the award of federal contracts. Therefore, it is important that your information be as factual, accurate and as complete as possible to preclude the need for follow-up queries by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does.

Completed questionnaires must be returned via email to the Government’s Contract Specialist, Mr. Eric Hertl, eric.c.hertl.civ@mail.mil NLT ----Fill in Proposal Due Date __________.

PART A. ADMINISTRATIVE (To be completed by Offeror)

1. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type: ( ) Cost Reimbursement ( ) Fixed Price ( ) Time & Material ( ) Fixed Price Incentive ( ) Other:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Nature of the Contractual Effort or Items Purchased:

2. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART B. PAST PERFORMANCE ASSESSMENT (To be completed by Respondent)

1. Compliance of products, services, documents and related contract deliverables to specification requirements and standards of good workmanship.

__ Acceptable, Meets Contractual Requirements __ Unacceptable, Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

Comments:

2. Effectiveness of overall project management.

__ Acceptable __ Unacceptable (Explanation must be provided in Comments field below)

3. Use and control of subcontractors.

__ Unacceptable (Explanation must be provided in Comments field below) __ N/A

4. Adherence to contract schedules, including timely submittal of documentation required throughout contract performance.

__ Acceptable, Meets Contractual Requirements __ Unacceptable, Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

5. Timeliness of Performance for Services and Product Deliverables, including the Administrative Aspects of Performance.

6. Effectiveness in forecasting and controlling project cost.

7. Commitment to customer satisfaction and business-like concern for its customer’s interest.

8. Overall satisfaction with contractor’s performance.

9. General Comments. Provide any other relevant performance information.

PART C: RESPONDENT IDENTIFICATION (to be completed by respondent)

Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone:

Email Address:

PART D: RETURN INFORMATION

Completed questionnaires must be returned via email to the Government’s Contract Specialist, Mr. Eric Hertl, eric.c.hertl.civ@mail.mil no later than Fill in Proposal Due Date __________.

Thank you for your participation.