Attachment 0009 - Past Performance Questionniare.pdf

CUI//SP-PROCURE

Past Performance 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. Please return the completed Questionnaire within fifteen (15) days after receipt. Thank you.

PART I. (To be completed by the Offeror)

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:

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

Exceeds Contractual Requirements (Explanation must be provided in Comments field below) Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

Comments:

Exceptional (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below)

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFERORS REPRESENTATIVE

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

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

Exceeds Contractual Requirements (Explanation must be provided in Comments field below)

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

Extremely Satisfactory (Explanation must be provided in Comments field below)

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:

Organization:

Name:

Title:

Date:

Telephone Number Address:

Fax Number:

E-mail Address:

C. Timeliness of Performance for Product Deliverables, including the Administrative Aspects of Performance.

D. Effectiveness in Forecasting and Controlling Project Cost.

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

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

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

I. Respondent Identification. Please provide the following information:

F. Overall Satisfaction

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer identified in the cover letter.

Thank you for your assistance.