ATTACHMENT 1 Past_Performance Questionnaires.pdf

ATTACHMENT 1

Reference for:____________________________________________________

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

SECTION 1: CONTRACT INFORMATION

A. Contract number: ______________________________________________

B. Contract type: _________________________________________________

C. Was this a competitive contract? Yes ☐ No ☐

D. Period of performance: _________________________________________ E. Place of performance: __________________________________________ F. Contract Value: _______________________________________________ G. Description of service provided:

H. Government Contracts Only: Was this contract partially or completely terminated for default or convenience or are there any pending terminations?

NO ☐ YES: Default ☐ Convenience ☐ Pending Termination ☐

If yes, please explain (e.g., inability to meet cost, performance, delivery schedules, etc).

SECTION 2: EVALUATOR’S INFORMATION

A. Company/Agency: ______________________________________________________ B. Evaluator's name and title: ________________________________________________ C. Evaluator's phone and email: ______________________________________________

D. Number of years evaluator worked on subject contract: _________________________

SECTION 3: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

O OUTSTANDING - The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example to others.

G GOOD – There are no or very minimal issues and the contractor has met the contract requirements.

A ACCEPTABLE – Overall compliance required minor involvement by evaluator’s personnel to ensure achievement of contract requirements.

U UNSATISFACTORY – Non-conformances jeopardized the achievement of contract requirements, despite use of evaluator’s resources. Constitutes a significant impediment in consideration for future awards containing similar requirements.

N NOT APPLICABLE - Unable to provide a score.

Quality of Product or Service O G A U N Ability to understand/comply with customer objectives and technical requirements Adequacy/effectiveness of quality control program

Program Management, Timeliness of Performance & Business Relations O G A U N Overall contract management (including the ability to lead, manage and control the program)

Contract problems resolved in a timely and effective manner without extensive customer guidance

Contract problems resolved in a timely and effective manner without extensive customer guidance

Level of professionalism and cooperation when dealing with your staff.

Would you hire this contractor in the future to perform one of your critical and demanding programs?

Yes ☐ No ☐

Please provide any additional comments concerning this contractor’s performance, as desired.

Evaluator’s Signature Date

ATTACHMENT 1