B08_Attachment_4_Past_Performance_Questionnaire.docx

When completed, this document is source selection sensitive and the Service will use it only for evaluation of this proposal and not share it outside of the evaluation team.

PAST PERFORMANCE QUESTIONNAIRE

SECTION 1: CONTRACT IDENTIFICATION INFORMATION

Consultant Name (Enter the name of the company being evaluated in this questionnaire)

Project Type (Define if the project was standalone or part of an overall contract.)

Period of Project Performance

Initial Project Cost

Final Project Cost

Reason(s) for Differences Between Initial Project Cost and Final Project Cost Shown Above:

Scope of Work Performed or Description of Services Provided

Evaluator Information (Information pertaining to individual completing this questionnaire.)

Name

Title

Phone

E-mail

Fax

Number of Months Worked on Contract

SECTION 2: QUALITY OF CONSULTANT PERFORMANCE

Use the following rating scale to indicate your satisfaction with the consultant’s performance in the specified areas by placing an “X” in the appropriate block.

RATING CODE PERFORMANCE CHARACTERISTICS

Technical Performance

Ability to accomplish project technical requirements and implement high quality standards

Ability to meet project schedule

Quality/Integrity of technical data, reports and analyses provided for project

Management Approach

Effectiveness of overall project/program management (including ability to lead/manage/control the project effort)

Reasonable and cooperative in dealing with your personnel

Timeliness/effectiveness of project problem resolution

Understood/complied with your objectives and technical requirements

Ability to hire and provide a highly qualified workforce

Ability to retain quality personnel

Managed subcontractors effectively

Effectively performed quality control/quality check on subcontractor deliverables

You may provide more information on additional pages, not to exceed 2 pages.