Attachment B-Past Performance Survey.docx
DOCX document 28 KB Posted
- Attached to
- DOS Overseas Furniture Install Services
- Solicitation number
- 19AQMM26R0279
About this file
This file is a Past Performance Survey template designed to evaluate contractor performance on Department of State overseas furniture installation projects. The survey appears to be a structured questionnaire that collects feedback from government representatives regarding vendor capabilities and past performance in executing furniture installation services at overseas DOS facilities.
As a template document, this survey serves as an assessment tool rather than a specification of required services or deliverables. It is intended to be completed by government evaluators or past clients to document contractor experience with systems furniture installation, project scheduling, labor coordination, and ability to manage the scope of work outlined in the solicitation (installations ranging from 10-200 desks with project timelines of 1-4 weeks). The survey would be used during the evaluation process for the DOS Overseas Furniture Install Services solicitation (19AQMM26R0279), a 100% Small Business set-aside requiring NAICS Code 238390 certification, with responses due by August 28, 2026 at 5:00 PM EST.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment C- Statement of Work 9-09-2026.docx | DOCX document | |
| DD-254 Revised 09 092026.pdf | ||
| 19AQMM26R0279 P00002.pdf | ||
| 19AQMM26R0279P0001.pdf | ||
| Attachment E-Wage Determination Revised 8-27-2026.pdf | ||
| Attachment C- Statement of Work 8-27-2026.docx | DOCX document | |
| Q and A Round 2 19AQMM26R0279 8-27-2026.docx | DOCX document | |
| Bidders DD 254 Revised 08 18 2026.pdf | ||
| Attachment E-Wage Determinations-USA work only.pdf | ||
| Attachment A-Price Sheet -Revised- 8-13-2026.docx | DOCX document | |
| Attachment D- Security Information.pdf | ||
| Q and A Round 1 19AQMM26R0279 8-07-2026.docx | DOCX document | |
| Bidders DD-254.pdf | ||
| Attachment C- Statement of Work.docx | DOCX document | |
| 19AQMM26R0279.pdf | ||
| Attachment A-Price Sheet.docx | DOCX document |
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Text version
Attachment B
PAST PERFORMANCE SURVEY
Furniture Installation Services
19AQMM26R0279
CONTRACT INFORMATION
Please provide the following information to assist us in tracking responses received and resolving any conflicts in the evaluation process if necessary.
a. Contractor: ____________________________________________
b. Contract Number: _______________________________________
Name of Evaluator: _________________________________________
Telephone Number: ________________________________________
Facsimile Number: _________________________________________
Organization/Office Symbol: ________________________________
Mailing Address: __________________________________________
Position/Title/Grade: _______________________________________
Length of Involvement with Contract: __________________________
Degree or extent of involvement with contract: ___________________
Period of Performance: __________ to ___________
Initial Contract Value: $___________________
Current or Completed Contract Value $___________________
Brief Description of Requirement: __________________________________________
Complexity of Effort: ( )Difficult ( )Routine
Thank you in advance for completing this survey. THIS INFORMATION WILL BE PROTECTED IN ACCORDANCE WITH FAR 15.1004 (e).
SCORING CRITERIA
EXCEPTIONAL - Indicates the Contractor's performance within the area of evaluation clearly and consistently exceeds contractual requirements.
ACCEPTABLE - Indicates no problem in area of evaluation or has only minor problems for which solutions were satisfactory.
UNACCEPTABLE - Indicates serious problems in the evaluation area. The Contractor is/was in danger of being unable to satisfy contractual requirements and timely recovery is not likely or did not occur.
l. CONFORMANCE TO SPECIFICATIONS AND STANDARDS OF GOOD WORKMANSHIP 1a. Overall ability to pro-actively and aggressively perform contract requirements.
Please circle the appropriate rating below or check if N/A.
| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ____________________________________________________________
1b. Effectiveness and reliability of contractor's Key Personnel.
Please circle the appropriate rating below or check if N/A.
| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments:______________________________________________________________
1c. Ability to effectively implement "start up" contract performance.
Please circle the appropriate rating below or check if N/A.
| 0 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments:______________________________________________________________
ll. ADHERANCE TO CONTRACT SCHEDULE 2a. Overall performance in planning, scheduling, and monitoring.
Please circle the appropriate rating below or check if N/A.
| 0 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ________________________________________________________________
2b. Completion of major milestones on schedule.
Please circle the appropriate rating below or check if N/A.
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ________________________________________________________________ 2c. Timely completion within period of performance.
Please circle the appropriate rating below or check if N/A.
| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
III. GENERAL BUSINESS CONDUCT AND BUSINESS-LIKE CONCERN FOR THE CUSTOMER
3a. Responsiveness and flexibility in responding to changes.
Please circle the appropriate rating below or check if N/A.
| · 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ____________________________________________________________ 3b. Responsiveness/capability to respond to surge/short term requirements.
Please circle the appropriate rating below or check if N/A.
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ___________________________________________________________ 3c. Accuracy and completeness of vouchers/invoices.
Please circle the appropriate rating below or check if N/A
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: __________________________________________________________
IV. COMPLIANCE WITHT THE TERM AND CONDITIONS OF THE CONTRACT
4a. Quality, completeness, and accuracy of the price proposals.
Please circle the appropriate rating below or check if N/A
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ____________________________________________________________ 4b. Accuracy and timeliness of required reports.
Please circle the appropriate rating below or check if N/A
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ____________________________________________________________ 4c. Ability to perform within negotiated prices.
Please circle the appropriate rating below or check if N/A
| 0 1 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Unacceptable | Acceptable | Exceptional |
Comments: ____________________________________________________________ image4.jpg image1.jpg image2.jpg image3.jpg
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