Attachment 3 - Past Performance Questionnaire.pdf
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- Solicitation number
- 70Z02326R93150001
About this file
This is a Past Performance Questionnaire template used to collect feedback from government agencies and contracting officers regarding contractor performance on completed or ongoing contracts.
The questionnaire is organized into four main sections. Section 1 captures contract identification information including the firm or agency providing feedback, project name, period of performance, contract type, award date, completion date, awarded value, and current contract dollar value. Section 2 requires the assessing official's name, email, phone number, their association with the firm being rated, and the contract or order number. Section 3 presents eight standard assessment categories plus two additional areas for evaluation: Quality of Product or Service, Schedule, Cost Control, Business Relations, Management of Key Personnel, Reliability, Customer Support, and Overall Performance. Each category must be rated using a six-point scale: Unsatisfactory, Marginal, Satisfactory, Very Good, Exceptional, or N/A. Section 4 provides space for additional comments to support the ratings.
The second page includes Table 2, which defines the performance rating levels. "Exceptional" indicates performance exceeding contractual requirements with few minor issues. "Very Good" represents performance meeting requirements and exceeding some expectations with minor issues. "Satisfactory" means performance meets contractual requirements with some minor problems. "Marginal" indicates performance not meeting some contractual requirements with serious unresolved issues. "Unsatisfactory" reflects performance failing to meet most requirements with serious unresolved problems unlikely to be corrected timely. "Not Rated" applies when criteria are not applicable or have no performance history.
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Text version
Past Performance Questionnaire
1. NAME OF FIRM/AGENCY PROVIDING FEEDBACK:
PROJECT NAME:
PERIOD OF PERFORMANCE: CONTRACT TYPE (if applicable):
CONTRACT AWARD DATE: CONTRACT COMPLETION DATE:
AWARDED VALUE: CURRENT CONTRACT DOLLAR VALUE:
2. NAME OF ASSESSING OFFICIAL:
EMAIL: PHONE NUMBER:
ASSOCIATION WITH FIRM BEING RATED (including role):
CONTRACT OR ORDER NUMBER (if applicable):
3. ASSESS THE FOLLOWING AREAS: (Check the appropriate box for each assessment category)
4 ADDITIONAL COMMENTS:
Assessment Categories Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A
a. QUALITY OF PRODUCT OR SERVICE
b. SCHEDULE
c. COST CONTROL
d. BUSINESS RELATIONS
e. MANAGEMENT OF KEY PERSONNEL
f. RELIABILITY
g. CUSTOMER SUPPORT
h. OVERALL PERFORMANCE
i. OTHER AREAS:
(1)
(2)
TABLE 2 - PERFORMANCE RATINGS DEFINITIONS
Rating Description
Exceptional Performance meets contractual requirements and exceeds many to the Government's benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Satisfactory Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
Marginal Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.
Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Not Rated Not applicable or has no history.
| 1 NAME OF FIRMAGENCY PROVIDING FEEDBACK: |
| PROJECT NAME: |
| PERIOD OF PERFORMANCE: |
| CONTRACT TYPE if applicable: |
| CONTRACT AWARD DATE: |
| CONTRACT COMPLETION DATE: |
| AWARDED VALUE: |
| CURRENT CONTRACT DOLLAR VALUE: |
| 2 NAME OF ASSESSING OFFICIAL: |
| EMAIL: |
| PHONE NUMBER: |
| ASSOCIATION WITH FIRM BEING RATED including role: |
| CONTRACT OR ORDER NUMBER if applicable: |
| Assessment Categories: |
| Unsatisfactorya QUALITY OF PRODUCT OR SERVICE: |
| Marginala QUALITY OF PRODUCT OR SERVICE: |
| Satisfactorya QUALITY OF PRODUCT OR SERVICE: |
| Very Gooda QUALITY OF PRODUCT OR SERVICE: |
| Exceptionala QUALITY OF PRODUCT OR SERVICE: |
| NAa QUALITY OF PRODUCT OR SERVICE: |
| Unsatisfactoryb SCHEDULE: |
| Marginalb SCHEDULE: |
| Satisfactoryb SCHEDULE: |
| Very Goodb SCHEDULE: |
| Exceptionalb SCHEDULE: |
| NAb SCHEDULE: |
| Unsatisfactoryc COST CONTROL: |
| Marginalc COST CONTROL: |
| Satisfactoryc COST CONTROL: |
| Very Goodc COST CONTROL: |
| Exceptionalc COST CONTROL: |
| NAc COST CONTROL: |
| Unsatisfactoryd BUSINESS RELATIONS: |
| Marginald BUSINESS RELATIONS: |
| Satisfactoryd BUSINESS RELATIONS: |
| Very Goodd BUSINESS RELATIONS: |
| Exceptionald BUSINESS RELATIONS: |
| NAd BUSINESS RELATIONS: |
| Unsatisfactorye MANAGEMENT OF KEY PERSONNEL: |
| Marginale MANAGEMENT OF KEY PERSONNEL: |
| Satisfactorye MANAGEMENT OF KEY PERSONNEL: |
| Very Goode MANAGEMENT OF KEY PERSONNEL: |
| Exceptionale MANAGEMENT OF KEY PERSONNEL: |
| NAe MANAGEMENT OF KEY PERSONNEL: |
| Unsatisfactoryf RELIABILITY: |
| Marginalf RELIABILITY: |
| Satisfactoryf RELIABILITY: |
| Very Goodf RELIABILITY: |
| Exceptionalf RELIABILITY: |
| NAf RELIABILITY: |
| Unsatisfactoryg CUSTOMER SUPPORT: |
| Marginalg CUSTOMER SUPPORT: |
| Satisfactoryg CUSTOMER SUPPORT: |
| Very Goodg CUSTOMER SUPPORT: |
| Exceptionalg CUSTOMER SUPPORT: |
| NAg CUSTOMER SUPPORT: |
| Unsatisfactoryh OVERALL PERFORMANCE: |
| Marginalh OVERALL PERFORMANCE: |
| Satisfactoryh OVERALL PERFORMANCE: |
| Very Goodh OVERALL PERFORMANCE: |
| Exceptionalh OVERALL PERFORMANCE: |
| NAh OVERALL PERFORMANCE: |
| Unsatisfactoryi OTHER AREAS: |
| Marginali OTHER AREAS: |
| Satisfactoryi OTHER AREAS: |
| Very Goodi OTHER AREAS: |
| Exceptionali OTHER AREAS: |
| NAi OTHER AREAS: |
| 1: |
| Unsatisfactory1: |
| Marginal1: |
| Satisfactory1: |
| Very Good1: |
| Exceptional1: |
| NA1: |
| 2: |
| Unsatisfactory2: |
| Marginal2: |
| Satisfactory2: |
| Very Good2: |
| Exceptional2: |
| NA2: |
| 4 ADDITIONAL COMMENTS: |
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