ATTACHMENT 4 - Past Performance Questionnaire.docx
DOCX document 19 KB Posted
- Attached to
- Food Price Data Collection
- Solicitation number
- RFQ12319824Q0020
About this file
This document is a Past Performance Questionnaire related to Solicitation Number RFQ12319824Q0020 for "Developing Innovative Approaches for Collecting Food Price Data in U. S. Territories and the Non-Contiguous States". The questionnaire requests information from a contractor's reference regarding their past performance, including management of subcontractors, working relationships with government personnel, quality control, schedule performance, and ability to rectify problems. The reference is asked to provide an overall performance rating and indicate whether they would award another contract to the contractor. This is a commercial services solicitation issued by the Department of Agriculture Food and Nutrition Service, open to small businesses under NAICS Codes 541611 and 541910.
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Text version
ATTACHMENT 3
PAST PERFORMANCE QUESTIONNAIRE FOR
SOLICITATION NUMBER: 12319824Q0020
THIS FORM IS PROVIDED FOR THE PURPOSE OF PROVIDING TO
AND SUBMITTAL BY THE VENDOR REFERENCES
Our company is being considered in a Source Selection by the Food and Nutrition Service (FNS), Contract Management Division (CMD). It would be appreciated if you would provide comments regarding our past performance. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition Regulation (FAR) prohibits the release of the names of individuals providing reference information about a Vendors past performance. In order to maintain the integrity of the source selection process, respectfully request that you do not divulge the name of the contractor nor discuss your comments on this questionnaire with any other individuals.
This form shall be sent via e-mailed to: Chantey Bost at chantey.bost@usda.gov.
Past Project Information:
1. Contractor name and address:
2. Contract Number and Project Title:
Evaluator (The following information will assist in the analysis of the data. Information will be kept confidential.)
| 1. | Name of Evaluator: | Date: |
| 2. | Phone Number: | |
| 3. | Address: | |
| 4. | Position held or function in relation to the project: |
RATINGS:
Please evaluate the contractor’s performance using the following ratings:
| (E) | Exceptional: | The contractor’s performance greatly exceeded the stated requirements. | |
| (HA) | Highly Acceptable: The contractor’s performance exceeded the stated requirements. | ||
| (A) | Acceptable: | The contractor’s performance met the stated requirements. | |
| (M) | Marginal: | The contractor’s performance met the stated requirements, but with | difficulty. |
| (U) | Unacceptable: | The contractor’s performance did not meet the stated requirements. |
Please rate and provide any supporting information for the following: (Use additional sheets as necessary)
1. The contractor’s on-site management and coordination of subcontractors.
2. The contractor’s ability to maintain a professional working relationship with Government personnel.
3. The contractor’s ability to provide qualified personnel to meet performance objectives as outlined in the Performance Work Statement or Statement of Work.
5. The contractor’s quality control ability.
6. The contractor’s ability to meet the performance schedule.
7. Was the contractor provided an opportunity to discuss any negative performance ratings? If so, what were the results?
8. The contractor’s ability to rectify identified problems in a timely fashion without further incident of the same.
9. Has the contractor been given any of the following: Cure notice; show cause, letters of reprimand, suspension of payments, termination? If yes, please explain.
10. Would you award another contract to this contractor? If no, please explain.
11. Was the contractor provided an opportunity to discuss any negative performance ratings? If so, what were the results?
12. The contractor maintained a professional working relationship with Government personnel.
OVERALL RATING: _________________________
Please provide any additional comments.
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