Attach_7_Past Performance Questionnaire.pdf
PDF 457 KB Posted
- Attached to
- IRV Exhaust and Vacuum Pump Replacement
- Solicitation number
- 75F40126R00049
About this file
This is a Past Performance Questionnaire template for use in evaluating contractor performance on federal contracts, specifically for RFP 75F40126R00049 related to an IRV Lab Exhaust & Vacuum Pump procurement (OC-2026-133488).
The questionnaire is designed to be completed by government representatives or contracting officers who have direct experience with a contractor's past performance. It captures reference information (name, title, email, phone, and agency/company of the reference) and contract details (contract number, total value, period of performance, prime or subcontractor status, and description of products/services provided). The form evaluates contractor performance across seven rated assessment elements using a five-point scale: Very Good (VG), Satisfactory (S), Marginal (M), Unacceptable (U), and Not Applicable (NA). The assessment categories are: (1) Cost/Price Control, (2) Schedule Adherence, (3) Performance, (4) Quality, (5) Business Relations, (6) Personnel Qualifications, and (7) Overall Rating. Each category requires a rating selection and supporting narrative explanation. The questionnaire also includes three open-ended questions requesting identification of contractor strengths and weaknesses, and whether the respondent would award to the contractor again with justification. A certification statement confirms the accuracy of ratings and comments provided by the signatory.
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Text version
ATTACHMENT 7
IRV Lab Exhaust & Vacuum Pump
OC-2026-133488 / RFP 75F40126R00049
PAST PERFORMANCE QUESTIONNAIRE
Offeror Name:
Name of Reference:
Title/Role:
Email: Phone:
Agency/Company:
CONTRACT INFORMATION:
Contract #:
Total Contract Value ($):
Period of Performance:
Was the Offeror Prime or Sub?
Description of product/service provided:
RATING CATEGORIES:
RATING CODE PERFORMANCE LEVEL
Very Good VG Performance meets contractual requirements and exceeds several requirements. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Satisfactory S Performance meets contractual requirements. The contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
Marginal M Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor's proposed actions appear only marginally effective or were not fully implemented.
Unacceptable U Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.
Not Applicable NA Unable to provide a score. Performance in this area not applicable to effort assessed.
Using the rating categories on page 1, check the appropriate box for each assessment element and provide supporting narrative.
(1) Cost/Price Control – Rate the contractor's ability to control cost and deliver at the agreed-to price. Describe the reasons for changes to contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes, etc.).
VG S M U NA
Supporting Narrative:
(2) Schedule Adherence – How well did the contractor adhere to the agreed-to schedule? What were the causes of any schedule variances? Were data deliverables and reports submitted on time?
VG S M U NA
Supporting Narrative:
(3) Performance – Rate the contractor's ability to successfully comply with the contract requirements, statement of work, subcontracting plan, etc.
VG S M U NA
Supporting Narrative:
(4) Quality – How well did the contractor adhere to the requirements of a Quality Assurance Plan or
Performance Based Contracting requirements? Did the services provided meet the required level of quality or results?
VG S M U NA
Supporting Narrative:
(5) Business Relations – Did the contractor exhibit reasonable/cooperative behavior in dealing with problems? Was turnover of personnel frequent? Rate the contractor's responsiveness to managing changes in providing replacement personnel.
VG S M U NA
ASSESSMENT ELEMENTS:
Supporting Narrative:
(6) Personnel Qualifications – Rate the contractor’s ability to staff and retain a highly-qualified team with the knowledge and experience required to successfully complete the project.
VG S M U NA
Supporting Narrative:
(7) What is your overall rating of the contractor’s performance?
VG S M U NA
Supporting Narrative:
(8) Please identify the contractor’s strengths.
(9) Please identify the contractor’s weaknesses.
(10) Given the choice, would you award to this contractor again? Why?
CERTIFICATION:
I certify that the ratings and comments reflected in this questionnaire were made by the undersigned and are accurate to the best of my knowledge.
Signature______________________________________ Date ________________
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