B08i_Attachment_8_-_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

READ CAREFULLY: The purpose of this form is for the offeror to list projects performed that are similar to the work described in this solicitation. Use this form to address your familiarity with the project requirements and with the evaluation criteria described in the solicitation. Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their experience may be considered by others to be less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s experience.

PART I: Solicitation and Contract Information (to be completed by Offeror)

Information Provided in Response to Solicitation Number:

Name of Offeror:

Project Name/Location:

Contract Number:

Contract Type:

Contract Value:

Client Organization:

Address:

Telephone Number:

Period of Performance or Date Completed:

DESCRIPTION OF THE PROJECT AND SCOPE OF WORK

PERFORMANCE REMARKS

(if problems were encountered on this contract, explain corrective action taken)

Part II: Performance Assessment (to be completed by client/ reviewer) Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise.

This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services.

The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.

1. Quality of product or service: (please double click on check box to check and uncheck box)

E |_| V |_| S |_| M |_| U |_| N |_|

Comment:

2. Schedule: (please double click on check box to check and uncheck box)

E |_| V |_| S |_| M |_| U |_| N |_|

Comment:

3. Management: (please double click on check box to check and uncheck box)

E |_| V |_| S |_| M |_| U |_| N |_|

Comment:

4. Regulatory Compliance: (please double click on check box to check and uncheck box)

E |_| V |_| S |_| M |_| U |_| N |_|

Comment:

Name and Title of Client/ Reviewer:

Signature: