Attachment D- Past Performance Questionnaire Cover sheet.docx

PAST PERFORMANCE QUESTIONNAIRE COVER SHEET

(NOTE TO OFFEROR: Offeror’s are to provide the following Past Performance Questionnaires (which includes Past Performance Questionnaire Cover sheet, Past Performance Questionnaire, and Adjective Ratings Definitions) to clients to be used as a reference. Past Performance Questionnaires are to be completed by a client of the Offeror, and submitted to the Government directly by that client. For each performance questionnaire submitted to a client, the Offeror will provide the Government with a copy of this cover sheet with their proposal. It shall identify the client’s point-of-contact information. It is the Offeror’s responsibility to ensure correct phone numbers and email addresses are provided for the client point of contact.)

1. OFFEROR:

2. FIRM PROVIDING EVALUATION:

3. CONTRACT NUMBER:

4. PROJECT DESCRIPTION:

5. CONTRACT/TASK ORDER AMOUNT:

6. PERFORMANCE PERIOD:

7. EVALUATOR’S CONTACT INFO:

a. NAME:

b. TITLE:

b. PHONE NUMBER:

c. FAX NUMBER:

d. EMAIL ADDRESS:

PAST PERFORMANCE QUESTIONNAIRE

PLEASE CIRCLE THE ANSWER OR ADJECTIVE RATING WHICH

BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1a. If so, was the services provided for heavy equipment, medium duty vehicles, light duty vehicles, or a combination of the three?

(circle as appropriate)

HEAVY EQUIPMENT

MEDIUM DUTY VEHICLES

LIGHT DUTY VEHICLES

2a. If so, was the services provided for heavy equipment, medium duty vehicles, light duty vehicles, or a combination of the three?

(circle as appropriate)

HEAVY EQUIPMENT

MEDIUM DUTY VEHICLES

LIGHT DUTY VEHICLES

COMMENTS: Objective Comments/ concerns relating to this Offeror.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

E (EXCELLENT) – Performance met contractual requirements and exceeded expectations in a manner that was beneficial to the customer. The contractual performance of the element being assessed was accomplished with few, if any, minor problems for which corrective actions taken by the Contractor were highly effective. (HIGH CONFIDENCE)

S (SATISFACTORY) – Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective action taken by the Contractor appear or were satisfactory. (SATISFACTORY CONFIDENCE)

M (MARGINAL) –Performance does not meet some contractual requirements. The contractual performance of the element being assessed 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. (LIMITED CONFIDENCE)

P (POOR) – Performance doe s not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element contains serious problem(s) for which the Contractor’s corrective actions appear or were ineffective. (NO CONFIDENCE)

N (NEUTRAL) – No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the Contractor or their key personnel. (This is neither a negative nor a positive assessment.)