Attachment J.2 - CPI Form.docx

Attachment J-2: Contractor Performance Information Form

PART I: Contractor Information (to be completed by Offeror)

1. Name of Prime Offeror (& Proposed Major Sub-Contractor, if applicable):

2. Name of Contracting Entity:

3. Award Number:

4. Award Type:

5. Award Value / Total Estimated Contract Value (TEC):

6. Total Obligated Value (value paid out):

7. Extraordinary Problems (if extraordinary problems were encountered on this contract, explain corrective action taken, per FAR 15.305(a)(2)):

8a. Contracting Officer (Name, Telephone Number, and Email address):

8b. Technical Officer/Contracting Officer’s Representative (Name, Telephone Number, and Email address):

9. Title of Award:

10. Scope of Work or Complexity/Diversity of Tasks:

11. Primary Location(s) of Work:

12. Detail any quality awards or certifications that indicate exceptional capacity to provide the service or product described in the statement of work:

13. Is this Award listed in the Contractor Performance Assessment Reporting System (CPARS) - (please circle your response and attach if “yes” and available): YES NO UNKNOWN

PART II: Performance Assessment (USAID will contact Reference to fill out, if record is not found in CPARS)

1. Quality of product or service, including consistency in meeting goals and targets: Assess technical activity critical to successful contract/order performance. Circle Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comment:

2. Schedule: Assess the timeliness against the completion of the Contract, Contracts, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance). Circle Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comment:

3. Cost Control: Assess the contractor’s effectiveness in forecasting, managing, and controlling contract/order cost as well as accuracy in financial reporting. Circle Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comment:

4. Management: Assess the history of professional behavior and overall business-like concern for the interests of the customer, including the Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts, cooperative attitude in remedying problems, and timely completion of all administrative requirements, management of key personnel, including appropriateness of personnel for the job and prompt and satisfactory changes in personnel when problems with clients where identified. Circle Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comment:

5. Regulatory Compliance: Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes (financial, environmental, safety, and other reporting requirements). Circle Rating:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comment:

6. Other: Specify additional evaluation areas that are unique to the contract/order, or that cannot be captured elsewhere in the evaluation. Comment:

7. Recommendation: Given what I know today about the contractor’s ability to perform in accordance with this contract or order’s most significant requirements, I WOULD or WOULD NOT (please circle your response) recommend them for similar requirements in the future.