Attachment J.5 - Past Performance Questionnaire.docx

ATTACHMENT J.5

PAST PERFORMANCE QUESTIONNAIRE

Offeror - please fill out the following questionnaire as clearly and as objectively as possible. The information you provide will be used for source selection purposes. Offeror, please send the completed questionnaire (Section A by the Offeror and B by the Reference) directly to the United States Agency for International Development (USAID) by email to usaidmoroccocontracts@usaid.gov and Ms. Salya Yacoubi, Supv. Senior Acquisition and Assistance Specialist, at syacoubi@usaid.gov with a copy to Zachary Clarke, Regional Contracting Officer, at zclarke@usaid.gov by the time and date indicated on the RFP cover page.

SECTION A: (To be filled by the Offeror)

Offeror's Name: ________________________________________________________________

Was the Offeror the Prime or Subcontractor on the project: ______________________________

Project Name: __________________________________________________________________

Project Scope/Description: _______________________________________________________

Period of Performance: __________________ Dollar Value of Contract: __________________

Primary Location(s) Work: ______________________________________________________

Name of Contact Person: _________________________________Phone: _________________

Date Contacted: __________________ Employer: ____________________________________

Contact’s Role or Knowledge of the Project: ________________________________________

SECTION B: (To be filled by the contact person named in Section A above)

“QUALITY”: 1. Please comment on your satisfaction with the Contractor’s quality of work:

“SCHEDULE”: 2. Please comment on the Contractor’s timeliness of contract performance: ______________________________________________________________________________

“MANAGEMENT”: 3. Please comment on the quality of your relations with the Contractor during contract performance: ______________________________________________________

“COST CONTROL”: 4. Please comment on the Contractor’s ability to control costs: ________

“REGULATORY COMPLIANCE”: 5. Please comment on the contractor’s ability to comply with applicable regulations: _______________________________________________________

“SMALL BUSINESS CONCERNS”: 6. For prime offerors who are not small business concerns, please comment on the Contractor’s utilization of Small Business concerns as subcontractors, including efforts in achieving small business participation goals: _____________

Please provide comments on Contractor’s Key Personnel: _______________________________ Page | 2