Attachment 6 - Past Performance Questionnaire.pdf

PAST PERFORMANCE INFORMATION QUESTIONNAIRE

Instructions:

References are asked to complete all items set forth in this Questionnaire and should return the completed and signed form electronically to the Requester and not the Contractor being evaluated.

Background Information

Name of Contractor being evaluated:

Name of Respondent, Position, and Title

Signature + Date of Respondent

Agency/Employer name:

Respondent’s Contact information:

Telephone: Fax: e-mail:

Referenced Contract/Order Number for which information is being provided:

Period of performance for referenced contract/order:

Contract/order award date:

Contract/order amount (including options exercised):

Contract type: Fixed-Price Cost Plus Incentive Fee

Labor-Hour/T&M

Cost Plus Award Fee

Cost Plus Fixed Fee

Other (Please provide Contract Type)

Was the Contractor for which this reference is being provided the Prime Contractor?

Yes No

Description of the contract/order work:

Names of key Contractor personnel (if applicable):

Evaluation

For each performance element identified below, references should evaluate performance of the firm or individual identified above in this form. Where the reference lacks sufficient information to provide an evaluation for a particular performance element, this should be noted. Where any deficiency or unfavorable information is identified, the reference should identify any mitigating factors that may weigh in favor of the person/firm on whose behalf the reference is provided (i.e., problems due to causes outside the contractor’s control). An individual within your organization who is knowledgeable of the Contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the Contractor’s performance with the judgment of others within their organization, as applicable.

Date this questionnaire was completed:

Evaluation of Past Performance

Please provide answers to the questions listed below. When responding to the questions listed, circle the letter that most accurately describes the contractor’s performance or situation (see the “ratings” chart below for a description of each letter). For any Marginal or Unsatisfactory rating, please provide explanatory narratives in the “Remarks” section at the bottom of this questionnaire. These remarks need not be lengthy, just detailed. If more space is required, attach additional pages. Handwritten responses to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.

Definitions of Potential Ratings for Questions Below:

Adjective Description Excellent (E) Possessing outstanding quality or merit, remarkably good.

Good (G) Possessing more than satisfactory quality or merit.

Satisfactory (S) Possessing adequate quality or merit.

Marginal (M) Possessing limited quality or merit.

Unsatisfactory (U) Possessing inadequate quality or merit.

Not Applicable (N/A)

Reference has no knowledge of Contractor’s past performance in this area, reference has insufficient information to provide a rating in this area, or question does not apply to the referenced contract.

1) QUALITY OF PRODUCT OR SERVICE

Contractor’s ability to meet minimum quality requirements specified in contract

Contractor’s ability to effectively control the quality of products or services provided

2) DAY TO DAY MANAGEMENT

Contractor’s ability to manage its financial and human resources to meet contract requirements

Contractor’s ability to recruit qualified personnel within a reasonable period of time

Contractor’s ability to effectively manage the contract/order from a contract administration standpoint

Contractor’s professionalism and business acumen

3) STAFF RECRUITMENT AND RETENTION

Contractor’s ability to provide and retain quality staff to within reasonable levels of turnover

4) TIMELINESS

Contractor’s ability to timely meet requirements for contract deliverables

Contractor’s ability to mitigate schedule risk when unanticipated events occur

5) COST CONTROL

Contractor’s ability to manage its resources within cost limitations set forth in the contract

Contractor’s ability to adequately and accurately track and report costs as required by the contract

OVERALL RATING:

Remarks