Attachment J-6 - Past Performance Questionnaire.doc
DOC document 85 KB Posted
- Attached to
- Canon ProStream Press Installation Design Build
- Solicitation number
- 040ADV-26-R-0029
- Issued by
-
Government Publishing Office
About this file
This is a Past Performance Questionnaire template used by the U.S. Government Publishing Office (GPO) to evaluate contractor performance during source selection for federal contract opportunities. The questionnaire is completed by both the contractor and the evaluating organization representative to document and assess prior performance on related projects.
The form requires contractors to provide basic contract information including contractor name and address, contract number, project name, period of performance, contract value, and type of contract. The evaluating organization representative completes the assessment section by rating the contractor across nine performance categories: Quality of Products and Services, Overall Performance, Schedule, Technical Requirements, Cost Control, Subcontracting, Customer Satisfaction (in routine matters), Customer Satisfaction (in unexpected difficulties), and Repeat Business likelihood. Each category uses a six-point rating scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Observed). The questionnaire also includes sections for documenting contractor weak points, strong points, other completed projects, and average award fee percentages if applicable. Responses are due by August 22, 2026, at 5:00 PM EST and should be submitted to gstevens@gpo.gov and twhite@gpo.gov. The information collected is designated as source selection sensitive and protected accordingly under 41 U.S.C. 423.
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Text version
Attachment J-6 Past Performance Questionnaire
Past Performance Questionnaire
ORGANIZATION’S PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this questionnaire and send by email to: gstevens@gpo.gov and twhite@gpo.gov
U.S. Government Publishing Office Acquisition Services
732 North Capitol Street, NW Room A530, Stop: AS Washington, DC 20401 Response Due Date Aug 22, 2026, at 5:00 PM EST
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY CONTRACTOR
1. CONTRACTOR’S NAME AND ADDRESS
3. CONTRACT NO.:
CONTRACT DATE:
4. PERIOD OF PERFORMANCE:
4. PACE OF PERFORMANCE:
5. COMPLETION DATE:
6. CONTRACT VALUE $
2. PROJECT NAME:
7. TYPE OF CONTRACT:
8. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:
Please add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
9. NAME AND ADDRESS OF EVALUATING ORGANIZATION:
EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other)
EVALUATOR’S PHONE NUMBER
MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please check the response code for each topic that best reflects your experience with this Contractor:
EX = Exceptional VG = Very Good S = Satisfactory MG = Marginal US = Unsatisfactory N/O = Not Observed
Quality of Products and Services- Assess the Contractor’s conformance to contract requirements.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Overall Performance- Assess the Contractor’s overall performance for the project.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Schedule- Assess the timeliness of the Contractor against the schedule of activities (as appropriate).
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Technical Requirements- Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Cost Control- Assess the Contractor’s willingness and ability to manage the contract budget and control costs.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Subcontracting- Assess the Contractor’s success at complying with subcontracting goals.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Customer Satisfaction- Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
Repeat Business- Assess the likelihood that you would want this Contractor to perform another contract for you in the near future.
FORMCHECKBOX
EX
FORMCHECKBOX
VG
FORMCHECKBOX
S
FORMCHECKBOX
MG
FORMCHECKBOX
US
FORMCHECKBOX
N/O
List Contractor’s Weak Points:
List Contractor’s Strong Points:
List any other projects this Contractor has completed for you:
If an award fee contract, what was the average award fee % earned?
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