Attachment - Past Performance Survey (Fillable).doc
DOC document 44 KB Posted
- Attached to
- THIRD PARTY TECHNICAL REVIEW: PORT AND AVIATION ASSISTANCE ACTIVITIES IN THE PACIFIC ISLANDS
- Solicitation number
- 1131PL26R0059
About this file
This is a Past Performance Survey template document designed to collect information about a contractor's previous work experience and performance history.
The survey serves as an evaluation tool for the Third Party Technical Review: Port and Aviation Assistance Activities in the Pacific Islands solicitation (1131PL26R26R0059), issued by the United States Trade and Development Agency on August 19, 2026, with a closing date of September 18, 2026 at 1:00 PM Eastern Time. As a fillable document, the template appears to be distributed to prospective offerors to complete and submit as part of their proposal package. The survey likely requests details regarding past projects, client references, project outcomes, schedule and cost performance, technical capabilities, and lessons learned relevant to port and aviation assistance activities. Offerors responding to this small business set-aside solicitation (NAICS 541690—Other Scientific and Technical Consulting Services) would use this form to demonstrate their qualifications and past performance in similar work to support their proposal evaluation under the Government's stated best-value criteria.
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Text version
Solicitation No.: 1131PL25R0059 Solicitation Title: Third-Party Technical Review: Port and Aviation Assistance Activities in the Pacific Islands
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, September 18, 2026, Arlington, VA Time. Survey must be submitted by the reviewer.
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:
PAGE
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