Attachment 1 - Past Performance Questionnaire.pdf
PDF 222 KB Posted
- Attached to
- Pueblo Warehouse Support
- Solicitation number
- 040ADV-26-R-0036
- Issued by
-
Government Publishing Office
About this file
This document is a Past Performance Questionnaire template developed by the U.S. Government Publishing Office (GPO) Acquisition Services to be completed by contractors and their customer references during the source selection process for federal contract opportunities.
The questionnaire is divided into two sections: contractor-completed information and evaluating organization representative-completed information. The contractor section requires identification details including contractor name and address, project name, contract number, contract date, period of performance, place of performance, completion date, contract value, and contract type, along with a description of the project's key characteristics. The evaluating organization section requires the customer reference's name, address, evaluator's name and position during project execution (Project Manager, Contracting Officer Representative, or other), phone number, and months of performance monitored. Customer references must submit completed questionnaires via email to the Contracting Officer Troy White (twhite@gpo.gov) and Contract Specialist Michaela Farmer (mfarmer@gpo.gov). The evaluator assesses contractor performance across nine rating categories using a six-point scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Observed): quality of products and services, overall performance, schedule adherence, technical requirements fulfillment, cost control, subcontracting compliance, customer satisfaction in routine matters, customer satisfaction in unexpected difficulties, and likelihood of repeat business. The form also requests identification of contractor weak points and strong points, listing of other completed projects, and average award fee percentage earned if applicable. The information is classified as Source Selection Sensitive Information under 41 U.S.C. 423 and must be protected accordingly.
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| File | Type | Posted |
|---|---|---|
| 040ADV-26-R-0036 - Final Version.pdf |
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Text version
Attachment 1 Past Performance Questionnaire
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. PLACE 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)
Customer references shall submit this completed questionnaire via email to the Contracting Officer, Troy White (twhite@gpo.gov) and Contract Specialist, Michaela Farmer (mfarmer@gpo.gov).
Attachment 3 Past Performance Questionnaire
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?
Past Performance Questionnaire
File details come from the government source that posted it. Updated .