J-5_PAST_PERFORMANCE_REFERENCE_SHEETS.pdf

PAST PERFORMANCE REFERENCE SHEETS

(To be removed at time of award)

Your immediate attention is requested. Please return completed survey form, in a sealed envelope, to the firm you are completing this survey for, NLT XXXX.

You have been identified as a reference for___________ (insert name of firm you are completing this survey for).

Using the rating table, please provide concise comments and ratings regarding your overall assessment of the offeror’s performance on the contract identified below. The proposed vendor will be responsible for submitting your sealed past performance survey form with its comprehensive proposal in response to the Government’s RFP. Please be aware that a rating without concise comments as to the basis for the rating may require the evaluators to contact you further for the necessary information, and may delay the evaluation process.

CONTRACT DESCRIPTION:

Contract Number:

Contract Type:

Award Amount:

Period of Performance:

Brief description of services provided by the offeror:

RATING TABLE

1. Poor: The Contractor lacked a basic understanding of the work and the capacity to fulfill the requirements.

Contractor’s performance was inadequate and contract requirements were often not met.

2. Moderate: The Contractor satisfactorily performed the services with some minor discrepancies. Overall performance was in accordance with the terms and conditions of the contract.

3. Good: The Contractor consistently met general contract requirements and understood customer needs. The

Contractor’s performance was thorough, comprehensive, and more than satisfactory. There is no history of practices or processes that were detrimental to the customer.

4. Superior: The Contractor demonstrated exceptional performance and innovative practices and/or processes.

The Contractor’s efficiency, productivity, and product enhancements lead to real cost savings and efficiencies for the customer. The Contractor consistently exceeded customer needs.

5. Not Applicable: Does not apply

QUALITY OF SERVICES

1. DID THE CONTRACTOR PROVIDE QUALITY PRODUCTS OR SERVICES?

Strengths:

Weaknesses:

Rating: 1 2 3 4 N/A

2. WAS THE CONTRACTOR COOPERATIVE AND RESPONSIVE TO CHANGING NEEDS OF THE

CUSTOMER?

3. DID THE OFFEROR, TEAM OR SUBCONTRACT ANY PART OF YOUR EFFORT TO ANOTHER

FIRM FOR COMPLETION? IF APPLICABLE, HOW WELL WAS THIS RELATIONSHIP MANAGED?

(ONLY APPLICABLE IF YOU ARE FILLING OUT THIS SURVEY FOR THE PROPOSED PRIME

CONTRACTOR.)

DELIVERY/COMPLETION

1. WERE THE CONTRACT/TASK DELIVERABLES COMPLETED ON TIME?

2. WERE THERE INSTANCES OF REQUIRED RE-WORK? WAS UNNECESSARY REWORK CAUSED

BY THE CONTRACTOR OR GOVERNMENT?

COST CONTROL

1. DID THE CONTRACTOR PROVIDE SERVICES AT OR BELOW THEIR INITIALLY PROPOSED

COSTS?

SYSTEMIC IMPROVEMENTS

1. DID THE CONTRACTOR ISOLATE PERFORMANCE PROBLEMS AND TAKE SYSTEMIC

IMPROVEMENT ACTION TO RESOLVE THE PROBLEMS?

2. DID THE CONTRACTOR SAVE/COST THE GOVERNMENT MONEY OR PROVIDE OTHER BENEFITS

(S) AS A RESULT OF INNOVATIVE WORK APPLICATIONS OR LACK THEREOF?

CONTRACTORS OVERALL PERFORMANCE

Please rate the contractors overall performance under this contract: 1 2 3 4

Comments:

YOUR COOPERATION IN COMPLETING THIS SURVEY IS GREATLY APPRECIATED.

Name of Reference: _______________________________________________________ Organization: ____________________________________________________________ Title: ___________________________________________________________________ Telephone: ___________________FAX________________Email__________________

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