Attachment 2 - Past Performance Questionnaire.docx

ATTACHMENT 2

Performance Assessment 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. An individual from the government will contact you concerning this Questionnaire to confirm the information is accurate. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

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: Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

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

· Satisfactory Confidence

· No Confidence

Rationale:

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

Rationale:

· Satisfactory ConfidenceC. Timeliness of Performance for Services and Product Deliverables.

Rationale:

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

Rationale:

E. Would you work with this company again?

· Yes

· No

Comments:

F. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

NOTE – Please ensure the contact information is accurate so the government may contact you to confirm the information provided in this questionnaire is accurate. Thanks for your time.