Attch 2 - Past Performance Questionnaire.pdf
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- Attached to
- FA442726Q1068 - Dorm Cameras, Amendment 02
- Solicitation number
- FA442726Q1068
About this file
This is a Past Performance Questionnaire template used to evaluate contractor performance on federal contracts. The form captures reference information including contract number, task order numbers if applicable, contract value, and the contractor's role as either prime contractor or sub-contractor. Respondents provide a description of work completed and rate the contractor across six performance dimensions: Quality, Schedule, Cost Control, Management, Small Business participation, and Regulatory compliance.
Each rating category offers five performance levels: Exceptional (exceeds contractual requirements with few minor problems and highly effective corrective actions), Very Good (exceeds some requirements with minor problems and effective corrective actions), Satisfactory (meets contractual requirements with minor problems and satisfactory corrective actions), Marginal (fails to meet some requirements with serious problems and marginally effective corrective actions), and Unsatisfactory (fails to meet most requirements with serious problems and ineffective corrective actions). The questionnaire requires respondents to provide justification for any rating other than satisfactory, along with additional remarks. The form concludes with respondent identification information including signature, name, email, phone number, and agency or company affiliation.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
1. Reference Information:
Contract Number (Include task order number(s)) if applicable:
Contract Value:
Contractor performed as: Prime Contractor Sub-Contractor
2. Description of Work Completed:
3. Contractor Performance Assessment Reporting Rating:
Below please provide a rating based on the following table to rate the contractor’s performance.
Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit.
The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit.
The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.
Unsatisfactory Performance does not meet most contractual requirements, and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Note: Ratings other than a satisfactory rating should include accompanying rationale to justify the higher or lower rating.
3.1: Quality Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
3.2: Schedule Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
3.3: Cost Control Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
3.4: Management Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
3.5: Small Business Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
3.6: Regulatory Rating:
Exceptional Very Good Satisfactory Marginal Unsatisfactory
Justification for rating:
Additional Remarks:
Respondents Signature Name:
Email:
Phone Number:
Agency/Company:
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