Attachment 3 - Past Performance Questionnaire.pdf
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- Solicitation number
- 1305M326Q0263
About this file
This is a Past Performance Questionnaire template used to evaluate contractor performance on federal contracts under Solicitation #1305M326Q0263.
The questionnaire is completed by past performance references and assesses contractors across four evaluation criteria: Quality of Service (adherence to contract requirements, specifications, and standards of workmanship); Schedule (timeliness in completing contracts, task orders, milestones, and deliverables); Cost Control (effectiveness in forecasting, managing, and controlling costs, applicable only to Time & Materials, Labor Hour, or Cost Reimbursable contracts, with N/A for Fixed Price); and Management (integration and coordination of activities, problem identification, corrective action plans, proposal submittals, contractor behavior, and customer satisfaction). Each criterion uses a five-point adjectival rating scale: Exceptional (exceeds requirements with few minor problems and highly effective corrective actions); Very Good (exceeds some requirements with minor problems and effective corrective actions); Satisfactory (meets requirements with minor problems and satisfactory corrective actions); Marginal (fails to meet some requirements with serious unaddressed problems); and Unsatisfactory (fails to meet most requirements with ineffective corrective actions and unlikely timely recovery). The questionnaire requires identification of the contractor, contract number, project title, period of performance, funded value, reference name, and reference role. It concludes with a binary recommendation question asking whether the reference would recommend the contractor for similar future requirements and provides space for additional comments and a signature (digital or traditional).
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ATTACHMENT 3: PAST PERFORMACE QUESTIONNAIRE
SOLICITATION # 1305M326Q0263
Source Selection Information
PAST PERFORMANCE QUESTIONNAIRE
Contractor Being Evaluated:
Contract number:
Project Title:
Period of Performance:
Total Funded Value:
Past Performance Reference Name:
Reference role on the project:
Questionnaire Instructions: Please assess the contractor’s performance on the referenced contract using the following adjectival rating scale:
ADJECTIVAL
RATING
DEFINITION
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.
Source Selection Information
1. QUALITY OF SERVICE. Assess the contractor’s performance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, or environmental standards).
Rating:
Comments:
2. SCHEDULE. Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or affect the schedule variance.
Rating:
Comments:
3. COST CONTROL. Assess the contractor’s effectiveness in forecasting, managing, and controlling cost. ***ONLY APPLICABLE FOR T&M, LH, or Cost Reimbursable Awards, Select N/A for
FFP***
Rating:
Comments:
4. MANAGEMENT. Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior, and customer satisfaction. Check the appropriate rating box.
Rating:
Comments:
Source Selection Information
Given what I know today about the contractor's ability to perform in accordance with this contract or order's most significant requirements, I ___would ___would not recommend them for similar requirements in the future.
ADDITIONAL COMMENTS, IF ANY:
PAST PERFORMANCE REFERENCE SIGNATURE [note: digital signature is acceptable]:
| PAST PERFORMANCE QUESTIONNAIRE |
| Contractor Being Evaluated: |
| Contract number: |
| Project Title: |
| Period of Performance: |
| Total Funded Value: |
| Past Performance Reference Name: |
| Past Performance Reference role on the referenced project: |
| 2. SCHEDULE. Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or affect the schedule variance. |
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| Dropdown1: [[Select Rating Below]] |
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| Dropdown4: [[Select Rating Below]] |
| Group4: Off |
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