Attachment IV- Past Performance Questionnaire.pdf

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Attached to
Shaw AFB Linen Rental and Laundering Services Federal contract opportunity
Solicitation number
HT940625QE017
Issued by
Defense Health Agency

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The document is a Past Performance Questionnaire, a standard form used to evaluate a contractor's performance across multiple assessment categories. The form provides space for detailed information about a contract, including the firm/agency name, project details, contract dates, award values, and an assessing official's contact information. The evaluation covers nine key performance areas: quality of product/service, schedule, cost control, business relations, management of key personnel, reliability, customer support, overall performance, and two additional custom areas. Ratings can range from Unsatisfactory to Exceptional, with an option for Not Applicable (N/A). The form requires detailed comments for ratings of Very Good and Exceptional, allowing the assessing official to provide specific feedback and substantiation for high-performance ratings.

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Other files for this federal contract opportunity

Other files attached to Shaw AFB Linen Rental and Laundering Services, newest first.
File Type Posted
Solicitation HT940625QE017 Q and A_3 September 2025.pdf PDF
Attachment II - Performance Work Statement.pdf PDF
Attachment I- Combined Synopsis-Solicitation HT940625QE017.pdf PDF
Attachment III - Pricing Sheet.xlsx XLSX spreadsheet

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Past Performance Questionnaire

1. NAME OF FIRM/AGENCY PROVIDING FEEDBACK:

PROJECT NAME:

PERIOD OF PERFORMANCE: CONTRACT TYPE (if applicable):

CONTRACT AWARD DATE: CONTRACT COMPLETION DATE:

AWARDED VALUE: CURRENT CONTRACT DOLLAR VALUE:

2. NAME OF ASSESSING OFFICIAL:

EMAIL: PHONE NUMBER:

ASSOCIATION WITH FIRM BEING RATED (including role):

CONTRACT OR ORDER NUMBER (if applicable):

3. ASSESS THE FOLLOWING AREAS: (Check the appropriate box for each assessment category)

4 ADDITIONAL COMMENTS:

Assessment Categories Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A

a. QUALITY OF PRODUCT OR SERVICE

b. SCHEDULE

c. COST CONTROL

d. BUSINESS RELATIONS

e. MANAGEMENT OF KEY PERSONNEL

f. RELIABILITY

g. CUSTOMER SUPPORT

h. OVERALL PERFORMANCE

i. OTHER AREAS:

(1)

(2)

For ratings of Very Good and Exceptional, provide comments supporting the rating.

1 NAME OF FIRMAGENCY PROVIDING FEEDBACK:
PROJECT NAME:
PERIOD OF PERFORMANCE:
CONTRACT TYPE if applicable:
CONTRACT AWARD DATE:
CONTRACT COMPLETION DATE:
AWARDED VALUE:
CURRENT CONTRACT DOLLAR VALUE:
2 NAME OF ASSESSING OFFICIAL:
EMAIL:
PHONE NUMBER:
ASSOCIATION WITH FIRM BEING RATED including role:
CONTRACT OR ORDER NUMBER if applicable:
Assessment Categories:
Unsatisfactorya QUALITY OF PRODUCT OR SERVICE:
Marginala QUALITY OF PRODUCT OR SERVICE:
Satisfactorya QUALITY OF PRODUCT OR SERVICE:
Very Gooda QUALITY OF PRODUCT OR SERVICE:
Exceptionala QUALITY OF PRODUCT OR SERVICE:
NAa QUALITY OF PRODUCT OR SERVICE:
Unsatisfactoryb SCHEDULE:
Marginalb SCHEDULE:
Satisfactoryb SCHEDULE:
Very Goodb SCHEDULE:
Exceptionalb SCHEDULE:
NAb SCHEDULE:
Unsatisfactoryc COST CONTROL:
Marginalc COST CONTROL:
Satisfactoryc COST CONTROL:
Very Goodc COST CONTROL:
Exceptionalc COST CONTROL:
NAc COST CONTROL:
Unsatisfactoryd BUSINESS RELATIONS:
Marginald BUSINESS RELATIONS:
Satisfactoryd BUSINESS RELATIONS:
Very Goodd BUSINESS RELATIONS:
Exceptionald BUSINESS RELATIONS:
NAd BUSINESS RELATIONS:
Unsatisfactorye MANAGEMENT OF KEY PERSONNEL:
Marginale MANAGEMENT OF KEY PERSONNEL:
Satisfactorye MANAGEMENT OF KEY PERSONNEL:
Very Goode MANAGEMENT OF KEY PERSONNEL:
Exceptionale MANAGEMENT OF KEY PERSONNEL:
NAe MANAGEMENT OF KEY PERSONNEL:
Unsatisfactoryf RELIABILITY:
Marginalf RELIABILITY:
Satisfactoryf RELIABILITY:
Very Goodf RELIABILITY:
Exceptionalf RELIABILITY:
NAf RELIABILITY:
Unsatisfactoryg CUSTOMER SUPPORT:
Marginalg CUSTOMER SUPPORT:
Satisfactoryg CUSTOMER SUPPORT:
Very Goodg CUSTOMER SUPPORT:
Exceptionalg CUSTOMER SUPPORT:
NAg CUSTOMER SUPPORT:
Unsatisfactoryh OVERALL PERFORMANCE:
Marginalh OVERALL PERFORMANCE:
Satisfactoryh OVERALL PERFORMANCE:
Very Goodh OVERALL PERFORMANCE:
Exceptionalh OVERALL PERFORMANCE:
NAh OVERALL PERFORMANCE:
Unsatisfactoryi OTHER AREAS:
Marginali OTHER AREAS:
Satisfactoryi OTHER AREAS:
Very Goodi OTHER AREAS:
Exceptionali OTHER AREAS:
NAi OTHER AREAS:
1:
Unsatisfactory1:
Marginal1:
Satisfactory1:
Very Good1:
Exceptional1:
NA1:
2:
Unsatisfactory2:
Marginal2:
Satisfactory2:
Very Good2:
Exceptional2:
NA2:
4 ADDITIONAL COMMENTS:

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