Attachment IX - Past Performance Survey (Fillable).doc
DOC document 44 KB Posted
- Solicitation number
- 1131PL24RDM21185
About this file
This document is a Past Performance Survey template related to a federal contract opportunity. The survey is for the Definitional Mission for Worldwide: MENA-EE and Indo-Pacific Water and Environmental contract, solicitation number 1131PL24RDM21185, issued by the United States Trade and Development Agency (USTDA). The survey requests information on the past performance of the contractor, including their ability to comply with contract terms, complete work on schedule, meet requirements, and take corrective measures. Respondents are asked to provide a rating of their confidence in the contractor and whether they would recommend doing business with the contractor in the future. The completed survey must be submitted to USTDA's Office of Acquisition Management by 1:00 PM on July 30, 2024. The contract opportunity is unrestricted and limited to U.S. firms or individuals. Contractor and subcontractor employees must be U.S. citizens or lawfully admitted permanent residents.
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Solicitation No.: 1131PL24RDM21185 Title: Definitional Mission for Worldwide: MENA-EE and Indo-Pacific Water and Environmental
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, July 30, 2024, 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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