Attachment J.4 - Past Performance Questionnaire (693JJ926R000067).docx

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Attached to
Countermeasures That Work (CMTW) Updates
Solicitation number
693JJ926R000067
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This is a Past Performance Questionnaire template for solicitation 693JJ926R000067, the Countermeasures That Work (CMTW) and Countermeasures At Work (CMAW) Guide Updates opportunity issued by the National Highway Traffic Safety Administration (NHTSA) under the Department of Transportation. The questionnaire is designed to be completed by references familiar with the offeror's relevant work, with a minimum of three (3) references required to submit responses directly to the Contract Specialist, Van A. Nixon, Jr., at NHTSAOAM@dot.gov by the proposal due date.

The questionnaire evaluates contractor performance across eight key elements using a five-point rating scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Applicable): quality of technical work and deliverables, ability to conduct and synthesize large-scale literature reviews, technical and scientific report writing quality including APA style compliance, timeliness in meeting milestones and deliverables, cost control and budget management, project management and staffing, responsiveness and communication with clients, and overall customer satisfaction. References must also provide a yes/no recommendation on whether they would award to the contractor again. The form includes sections for contractor and reference information, performance ratings in Part II, and narrative comments regarding the contractor's strengths, weaknesses, and overall performance in Part III, which requires a reference signature and date.

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ATTACHMENT J.3 - PAST PERFORMANCE QUESTIONNAIRE

Solicitation No. 693JJ926R000067 - Countermeasures That Work (CMTW) Update INSTRUCTIONS: The Offeror shall provide this questionnaire to at least three (3) references familiar with the Offeror's relevant work. References shall complete Parts I-III and submit the questionnaire directly to Van A. Nixon, Jr., Contract Specialist, at NHTSAOAM@dot.gov, no later than the proposal due date.

PART I - CONTRACTOR AND REFERENCE INFORMATION

Offeror (Contractor) Name

Contract / Project Title

Contract Number

Period of Performance

Total Contract Value

Reference Name and Title

Reference Organization

Reference Phone

Reference Email

Nature of Services Provided

PART II - PERFORMANCE RATINGS

Rate the contractor on each element using the scale: E = Exceptional, VG = Very Good, S = Satisfactory, M = Marginal, U = Unsatisfactory, N/A = Not Applicable.

Performance Element
Rating

Quality of technical work and deliverables

Ability to conduct and synthesize large-scale literature reviews

Technical/scientific report writing quality (including APA style)

Timeliness in meeting milestones and deliverables

Cost control and budget management

Project management and staffing

Responsiveness and communication with the client

Overall customer satisfaction

Would you award to this contractor again? (Yes/No)

PART III - NARRATIVE AND SIGNATURE

Please provide any narrative comments regarding the contractor's strengths, weaknesses, and overall performance:

Reference Signature: ______________________________ Date: ________________

File details come from the government source that posted it. Updated .