Attachment_5-_Past_Performance_Survey.docx

RFQ 1852136883

“Security Management & Support Services” Attachment 2

ATTACHMENT #5

PAST PERFORMANCE EVALUATION

1. Contractor (Name, Address and Zip Code):

2. Contract Number: __________________________________

3. Contract Type:

Negotiated Sealed Bid Fixed Price Cost Reimbursement Other (Specify)

4. Complexity of Work: Difficult Routine

5. Description of Work: (Attach additional pages as necessary.)

7. Date of Award: ____________

Contract Completion Date (Including Extensions): ____________

8. Type and Extent of Subcontracting: (Attach additional pages as necessary.)

9. Name, Address and Telephone Number of Contracting Officer's Technical Representative (COTR) - Government, or Company Representative - Commercial:

Ph# _________________ Fax# _____________________

A separate record must be completed for each individual contract that was performed within the past three years.

RFP DJF-16-1800-PR-0013521

Attn: Jerri Newton “Tactical Mesh/MANET Support” Attachment# 5

Page 2 - Past Performance Evaluation

PERFORMANCE EVALUATION OF CONTRACT

(Check Appropriate Box)

Performance Element

Neutral

Satisfactory

Marginal

Did the Contractor perform all of the contract requirements?

Did the Contractor meet the objectives of the statement of work?

Has all the contract work been inspected, accepted, and the Contractor paid for the work?

Will the Government be able to use the contract deliverable for the purpose intended?

Did the Contractor adhere to the contract delivery/performance schedule, including administrative aspects (e.g., monthly progress reports, etc.)?

Has the Contractor properly accounted for and disposed of all Government-furnished and Contractor-acquired property under the contract?

Was the Contractor reasonable, cooperative, and committed to satisfying he Government?

Would you recommend this contractor for future work of this nature?

Did the Contractor perform and support law enforcement activities?

Directly Indirectly Federal___ State ___ Local ___ No law enforcement support ___

EVALUATED BY:

Date: ____________________

Page 3 - Past Performance Evaluation

1. Remarks on outstanding performance: Provide data supporting this observation. (Continue on a separate sheet if needed.)

2. Remarks on unsatisfactory performance: Provide data supporting this observation. (Continue on a separate sheet if needed.)

3. Has this contract been partially or completely terminated for default or convenience?

( ) Yes ( ) Default ( ) Convenience ( ) No

If yes, explain (e.g., inability to meet cost, performance, or delivery schedules).

4. Are there any pending terminations?

( ) Yes ( ) No

If yes, explain and indicate the status.