Attachment 5 - Past Performance Questionnaire.pdf

PDF 135 KB Posted

Attached to
PKA -B812 Mold Abatement Federal contract opportunity
Solicitation number
FA442725Q1099
Issued by
Department of the Air Force Air Mobility Command

About this file

The Past Performance Questionnaire is a standardized form used to evaluate and document a contractor's performance across six key rating categories: Quality, Schedule, Cost Control, Management, Small Business, and Regulatory performance. The form provides a detailed rating scale ranging from Exceptional to Unsatisfactory, with specific definitions for each performance level. Ratings are intended to provide a comprehensive assessment of a contractor's capabilities, with the requirement that any rating other than Satisfactory must include accompanying rationale to justify the higher or lower rating. The document includes space for reference information such as contract number, contract value, and whether the contractor performed as a prime or sub-contractor, as well as sections for describing work completed, providing detailed ratings, and offering justification and additional remarks.

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Other files for this federal contract opportunity

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FA442725Q1099 B812 Mold Abatement RFIs.docx DOCX document
Attachment 1 - B812 Mold Abatement SOW 12 Jun 2025.pdf PDF
Combined Synopsis Solicitation - FA442725Q1099 B812.pdf PDF
Attachment 3 - Travis AFB Security Clause.pdf PDF
Attachment 4 - B812 Travis Fire Pump Room Mold Assessment 11 Apr 25.pdf PDF

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Text version

PAST PERFORMANCE QUESTIONNAIRE

1. Reference Information:

Contract Number (Include task order number(s)) if applicable:

Contract Value:

Contractor performed as: Prime Contractor Sub-Contractor

2. Description of Work Completed:

3. Contractor Performance Assessment Reporting Rating:

Below please provide a rating based on the following table to rate the contractor’s performance.

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit.

The contractual performance of the element or sub-element being evaluated 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 contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element 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 contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory Performance does not meet most contractual requirements, and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: Ratings other than a satisfactory rating should include accompanying rationale to justify the higher or lower rating.

3.1: Quality Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

3.2: Schedule Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

3.3: Cost Control Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

3.4: Management Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

3.5: Small Business Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

3.6: Regulatory Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Justification for rating:

Additional Remarks:

Respondents Signature Name:

Email:

Phone Number:

Agency/Company:

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