Attachment 3 - Past Performance Questionnaire.pdf

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Attached to
Legal Support Services
Solicitation number
93310023Q0023
Issued by

About this file

This document is a past performance questionnaire template to be completed by contractors and their clients regarding previous contracts. It requests information on the contractor being rated, the client including point of contact details, the contract or project name and number, period of performance, and brief description. It includes dropdown menus for the client to select adjective ratings for the contractor's quality of work, timeliness, resourcefulness, interpersonal skills, job knowledge, dependability, flexibility, and overall rating. It also includes fields for comments, signature, and release of information stating the completed report will be treated as source selection information.

The related federal contract opportunity is solicitation number 93310023Q0023 from the Federal Mediation and Conciliation Service seeking legal support services. It lists the solicitation name and type, and the contracting agency.

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Text version

PAST PERFORMANCE QUESTIONNAIRE

CONTRACT/PROJECT INFORMATION (To Be Completed by Contractor)

1. Contractor Being Rated:

2. Client Name:

Point of Contact:

Phone Number:

Email:

3. Contract/Project Name:

Contract Number (if applicable):

Period of Performance:

Brief Description:

PLEASE SELECT THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR

EVALUATION OF THE CONTRACTOR’S PERFORMANCE

1. Quality of work

2. Timeliness of work

3. Resourcefulness

4. Interpersonal skills

5. Job knowledge

6. Dependability

7. Flexibility

8. Overall Rating

9. Would you select this contractor again?

Any additional comments related to the contractor’s performance:

Name/Title of Person Completing the Form Signature Date

Release of Information: This Contractor Performance Report may be used to support future award decisions, and will be treated as source selection information in accordance with FAR 3.104-4(k)(1)(x) and 42.1503(b). The completed report shall not be released to other than Government personnel and the contractor whose performance is being evaluated during the period the information is being used to provide source selection information.

Date:
Contractor Being Rated:
Additional Comments:
Person Completing the Form:
Client Name:
Point of Contact:
Phone Number:
Email:
Brief Description:
Period of Performance:
Contract Number:
Contract Name:
Dropdown1: [Select Rating]
Dropdown2: [Select Rating]
Dropdown3: [Select Rating]
Dropdown4: [Select Rating]
Dropdown5: [Select Rating]
Dropdown6: [Select Rating]
Dropdown7: [Select Rating]
Dropdown8: [Select Rating]
Dropdown9: [Select One]

File details come from the government source that posted it. Updated .