Attachment V - Past Performance Survey (Fillable).doc
DOC document 44 KB Posted
- Attached to
- REGIONAL LATIN AMERICA AND CARIBBEAN: DEFINITIONAL MISSION FOR WATER AND ENVIRONMENT SECTOR OPPORTUNITIES
- Solicitation number
- 1131PL23RDM51155
About this file
This document contains a past performance survey template and information on a related federal contract solicitation. The survey template requests a contractor reference to provide feedback on an incumbent's past performance on a prior contract. Areas of evaluation include compliance with contract terms, schedule adherence, requirement fulfillment, and corrective action capabilities. The solicitation seeks proposals for definitional mission support services related to the water and environment sectors in Latin America and the Caribbean. Proposals are due by July 14, 2023 to the United States Trade and Development Agency. The solicitation is open only to U.S. firms or individuals for an award limited to less than 50% subcontracted work. Citizenship requirements are also specified.
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Text version
Solicitation Regional Latin America and Caribbean: Definitional Mission for Water and Environment Sector Opportunities Solicitation No.: 1131PL23RDM51155
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 1:00 PM, July 14, 2023, Arlington, VA Time.
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:
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