Attachment 1 - Past Performance Questionnaire.pdf

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Government Publishing Office (GPO) Building Information Model (BIM)
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040ADV-25-R-0026
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This document is a Past Performance Questionnaire issued by the U.S. Government Publishing Office Acquisition Services. The form is designed to evaluate a contractor's performance across multiple dimensions, including quality of products and services, overall performance, schedule adherence, technical requirements, cost control, subcontracting success, and customer satisfaction. The questionnaire provides a standardized method for assessing a contractor's performance using response codes ranging from Exceptional (EX) to Unsatisfactory (US), with sections for listing the contractor's weak and strong points, other completed projects, and potential for repeat business. The form is marked as Source Selection Sensitive Information and must be protected accordingly under 41 U.S.C. 423.

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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

File details come from the government source that posted it. Updated .