Attachment 1 - Past Performance Questionnaire.pdf
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- Solicitation number
- 040ADV-25-R-0024
- Issued by
-
Government Publishing Office
About this file
The document is a Past Performance Questionnaire from the U.S. Government Publishing Office Acquisition Services, designed to evaluate a contractor's performance on a specific project. The form provides a comprehensive assessment framework with rating scales ranging from Exceptional (EX) to Unsatisfactory (US) across nine key performance categories, including quality of products and services, overall performance, schedule adherence, technical requirements, cost control, subcontracting, and customer satisfaction. Evaluators are asked to provide detailed feedback by checking the appropriate response code for each category and have the option to list the contractor's weak and strong points, as well as other completed projects. The form is marked as Source Selection Sensitive Information and must be protected accordingly under 41 U.S.C. 423.
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Text version
Attachment 1
Past Performance Questionnaire
ORGANIZATION’S PERFORMANCE QUESTIONNAIRE
U.S. Government Publishing Office Acquisition Services 732 North Capitol Street, NW Room A530, Stop: AS Washington, DC 20401
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C.
423) and shall be protected accordingly.
TO BE COMPLETED BY CONTRACTOR
1. CONTRACTOR’S NAME AND ADDRESS
3. CONTRACT NO.:
CONTRACT DATE:
4. PERIOD OF PERFORMANCE:
4. PACE OF PERFORMANCE:
5. COMPLETION DATE:
6. CONTRACT VALUE $
2. PROJECT NAME:
7. TYPE OF CONTRACT:
8. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:
Please add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
9. NAME AND ADDRESS OF EVALUATING ORGANIZATION:
EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other)
EVALUATOR’S PHONE NUMBER
MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please check the response code for each topic that best reflects your experience with this Contractor:
EX = Exceptional VG = Very Good S = Satisfactory MG = Marginal US = Unsatisfactory N/O = Not Observed Quality of Products and Services- Assess the Contractor’s conformance to contract requirements.
EX VG S MG US N/O
Overall Performance- Assess the Contractor’s overall performance for the project.
EX VG S MG US N/O
Schedule- Assess the timeliness of the Contractor against the schedule of activities (as appropriate).
EX VG S MG US N/O
Technical Requirements- Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.
EX VG S MG US N/O
Cost Control- Assess the Contractor’s willingness and ability to manage the contract budget and control costs.
EX VG S MG US N/O
Subcontracting- Assess the Contractor’s success at complying with subcontracting goals.
EX VG S MG US N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
EX VG S MG US N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.
EX VG S MG US N/O
Repeat Business- Assess the likelihood that you would want this Contractor to perform another contract for you in the near future.
EX VG S MG US N/O
List Contractor’s Weak Points:
List Contractor’s Strong Points:
List any other projects this Contractor has completed for you:
If an award fee contract, what was the average award fee % earned?
Source Selection Information - See MMAR 2.101 and 3.104
| Attachment 1 |
| Past Performance Questionnaire |
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