Attachment C - Past Performance Questionnaire.doc
DOC document 92 KB Posted
- Solicitation number
- R5000078810
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Past Performance Questionnaire
Instructions:
Section II to be completed by the Offeror and provided to the Contractor (Entity that had experience with the Offeror on a previous relevant Contract/Project). The assessor is to verify sections II through III, complete the questionnaire, and submit to the Contracting Office.
If any information is incorrect herein, please annotate and provide the correct information accordingly.
Sections III through V to be completed in their entirety by the assessor.
Message to the assessor: Your feedback is requested by IRS Procurement to assist with establishing the performance history for the Contractor named below. In efforts to expedite receipt of the requested please e-mail the completed questionnaire(s) to: Carlos.Kinsman@irs.gov I. Solicitation Data (for the proposed effort)
Solicitation Number
| Project/Requirement |
| Disabled Employees Support Acquisitions |
| Customer/Agency |
| Internal Revenue Service |
| Project/Requirement Description |
| Establishment of IDIQ Assistive Technology (AT) Hardware, Software, Maintenance and Support Services |
II. Current or Historical Contract Information
Assessor: The performance data submitted by the Offeror is FORMCHECKBOX FILLIN \* MERGEFORMAT correct or FORMCHECKBOX incorrect.
CONTRACTOR NAME & ADDRESS:
Contract No
Type of Contract
| Contract Value |
| $ |
Period of Performance/Delivery Schedule
Project/Requirement Description
(Size, Scope and Complexity)
Please select from the following as it applies to this contract:
| Contracting Role |
| FORMCHECKBOX |
PRIME
FORMCHECKBOX
SUBCONTRACTOR
| Termination History |
| FORMCHECKBOX |
Convenience
FORMCHECKBOX
Default
FORMCHECKBOX
N/A
III. Assessor Information Assessor Name
Title
Phone Number/Email Address
Identify your role in the contract award or administration and the period of your involvement.
| ( |
| Role |
| Period of Involvement |
Procuring Contracting Officer (PCO)
Administrative Contracting Officer (ACO)
Contract Specialist
Contracting Officer’s Representative (COR)
Technical Project Lead/Project Officer
Information Technology Specialist
Other:
Evaluation Definitions The following definitions should be used in your assessment of Contractor performance.
| PASS |
| Vendor fulfills contractual requirements. The areas being assessed were accomplished successfully |
| FAIL |
| Vendor fails to meet contractual requirements. The areas being assessed were not accomplished successfully |
| N/A |
| Vendor assessment not available / not applicable |
IV. Performance Evaluation
1. Technical Capability
a. What is your OVERALL assessment of the Contractor’s ability to meet the technical requirements?
| Pass |
| Fail |
| NA |
Technical Capability
Please provide rationale for the assigned rating.
2. Schedule Adherence
a. What is your OVERALL assessment of the Contractor’s ability to meet schedule timelines?
| Pass |
| Fail |
| NA |
Schedule Adherence
Please provide rationale for assigned rating.
3. Project Management
a. What is your OVERALL assessment of the Contractor’s project management performance?
| Pass |
| Fail |
| NA |
Project Management
4. Cost Control
a. What is your OVERALL assessment of the Contractor’s ability to forecast, manage, and control costs?
| Pass |
| Fail |
| NA |
Cost Control
V. Overall Rating of Contractor’s performance (technical, schedule, management, and cost) on contract being assessed.
| Pass |
| Fail |
| NA |
Overall
General Comments:
Assessor’s Signature
Date
File details come from the government source that posted it. Updated .