Attachment III - Past Performance Survey (Fillable) .doc
DOC document 44 KB Posted
- Attached to
- DEFINITIONAL MISSION FOR REGIONAL SOUTH AND SOUTHEAST ASIA CLIMATE-SMART TRANSPORTATION OPPORTUNITIES
- Solicitation number
- 1131PL22RDM31283
About this file
This solicitation requests proposals for a definitional mission to identify climate-smart transportation opportunities in Regional South and Southeast Asia. Offerors must be registered in SAM.gov and have active status to be eligible for award. This 100% small business set-aside has a size standard of $16.5M annual sales under NAICS Code 541690. Only U.S. firms and individuals may receive award. Contractor and subcontractor employees must be U.S. citizens or lawful permanent residents. Subcontractors cannot comprise more than 50% of the proposed price. Proposals are due by September 12, 2022 and should include completed sections on supplies/services, contract clauses, contract documents and exhibits, and instructions to offerors. The United States Trade and Development Agency is the issuing federal agency.
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Solicitation: REGIONAL SOUTH AND SOUTHEAST ASIA FOR CLIMATE-SMART TRANSPORTATION DEFINITIONAL MISSION (DM) Solicitation No.: 1131PL22RDM31283
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, September 12, 2022, Arlington, VA Time.
Name of Contractor Being Reviewed:
Contract Number/Reference Information:
Name of Agency/Organization Submitting Review for this Contractor:
| Name of Person Completing Questionnaire |
| Phone Number |
| Email Address |
| Period of Performance: XX/XX/XXXX – XX/XX/XXXX |
| Brief Description of Services: XXXXXXXXX |
Total Contract Value: $XXXX.XX
Contract Performance Information
| Questions: |
| Response: |
| 1. How would you rate your confidence in the contractor’s ability to comply with contract terms and conditions? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 2. How would you rate your confidence in the contractor’s ability to complete work on schedule? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 3. How would you rate your confidence in the contractor’s ability to comply with the actual requirements? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 4. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
5. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.
· Yes
· No
Comment:
| 6. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss? |
| · Yes |
· No Comment:
USTDA sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.
Additional Comments:
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