B01 Attachment 5 Past Performance Questionnaire.pdf

ATTACHMENT 6 PAST PERFORMANCE QUESTIONNAIRE

PART I CONTRACT INFORMATION (Contractor to complete)

Project Title Award Value Period of Performance Prime Contractor or Subcontractor

☐ Prime ☐ Subcontractor

Agency or Entity Name and Address

PART II PERFORMANCE INFORMATION (Client to complete)

Name / Title Phone # Email Address Part I Contract Type Signature Instructions: Please select the adjective rating that best reflects your evaluation of the contractor’s performance.

See Part III for rating guidance.

Category Exceptional Good Satisfactory Marginal Unsatisfactory N/A

Quality ☐ ☐ ☐ ☐ ☐ ☐

Schedule ☐ ☐ ☐ ☐ ☐ ☐

Cost Control ☐ ☐ ☐ ☐ ☐ ☐

Management ☐ ☐ ☐ ☐ ☐ ☐

Small Business ☐ ☐ ☐ ☐ ☐ ☐

Regulatory Compliance

Comments (expand as needed)