Attachment-0007- Past Performance Questionnaire.pdf

ATTACHMENT 0007

Performance Assessment Questionnaire

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up 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 and/or notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Substantial Confidence: Based on the contractor’s recent performance on the relevant identified contract and contractual requirements, contractor past performance would indicate a high expectation of successful performance.

Satisfactory Confidence: Based on the contractor’s recent performance on the relevant identified contract and contractual requirements, contractor past performance would indicate successful performance.

Neutral Confidence: No contractor recent and/or relevant performance record is available subsequently, no meaningful confidence assessment can be provided. The contractor’s past performance is not assessed as favorably or unfavorably.

Limited Confidence: Based on the contractor’s recent performance on the relevant identified contract and contractual requirements, contractor past performance would indicate a low expectation of successful performance.

No Confidence: Based on the contractor’s recent performance on the relevant identified contract and contractual requirements, contractor past performance would indicate a no expectation of successful performance.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

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

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

Substantial Confidence Satisfactory Confidence Neutral Confidence Limited Confidence No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

Neutral Confidence

C. Timeliness of Performance for Services and Product Deliverables.

Neutral Confidence

D. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

Neutral Confidence

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

Comments: ________________________________________________________

F. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

G. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.

Thank you for your assistance.