Attachment III - Past Performance Survey (Fillable) .doc
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- Solicitation number
- 1131PL21RDM31184
About this file
This document contains a solicitation for a Definitional Mission for Information and Communication Technology Opportunities in South and Southeast Asia. The United States Trade and Development Agency is soliciting offers for a single-award, firm-fixed price contract with a cost-reimbursable contract line item number for other direct costs. The solicitation is set aside for small businesses under NAICS code 541690. Offerors must be registered in the System for Award Management with an active status and provide accurate DUNS/TIN information. Offers are due by August 20, 2021. Award is limited to U.S. firms and subcontractor employees must be U.S. citizens or permanent residents.
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Text version
Solicitation: Regional Asia: Definitional Mission (DM) for Information and Communication Technology (ICT) Opportunities DM Solicitation No.: 1131PL21RDM31184
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 4:00 PM, August 20, 2021, 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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