Attachment 2 - PAST PERFORMANCE QUESTIONNAIRE.pdf

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND FAR 3.104

PAST PERFORMANCE QUESTIONNAIRE

Instructions:

• The Offeror shall complete Section I and II.

• The Assessor shall complete Sections III-VII.

Message to the Assessor: Your assistance is requested by the agency to assist with providing feedback regarding the past performance of the Contractor named below. In efforts to expedite receipt of the requested information, the Contracting Officer respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to: [insert email address] by [insert date and time] that questionnaire must be returned]. Please sign and date the last page.

I. Solicitation Information (to be completed by the Offeror)

Solicitation Number

Project/Requirement

Agency

Project/Requirement Description

II. Contract Information for Past Performance Reference (to be completed by the Offeror)

CONTRACTOR NAME Contract No

Period of Performance/Delivery Schedule

Project/Requirement Description

Please select from the following as it applies to this contract:

Contracting Role

PRIME SUBCONTRACTOR

III. Assessor Information (to be completed by Assessor)

Assessor Name

Title

Name of Firm

Phone Number/Email Address

Identify your role in the contract award or administration and the period of your involvement.

Role Period of Involvement

Contracting Officer

Contract Specialist

Contracting Officer’s Representative (COR)

Other (please note)

IV. Evaluation Definitions

The following definitions must be used in your assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NEUTRAL No past performance. This is neither a negative nor positive assessment.

V. Performance Evaluation (to be completed by Assessor)

Performance Elements Exceptional Very Good Satisfactory Marginal Unacceptable N/A

Technical Quality

Subcontract & team management

Cost control & savings

Customer satisfaction & responsiveness

Performance schedules

Adapting to changed conditions

Timeliness of reports

VI. Overall Rating of Contractor’s Performance

Exceptional Very Good Satisfactory Marginal Unsatisfactory

VII. General Comments

Any comments are appreciated; however, at a minimum please provide rationale for ratings of marginal or unsatisfactory for both the individual element and overall ratings.

Assessor’s Signature Date

Enter Contract Name, and Address