Attachment 1(G) Past Performance Survey.pdf

DJM-13-A32-R-0003

PAST PERFORMANCE SURVEY

Attachment 1(G)

1. Contractor Name and Address (Identify Division):

2. Contractor Number:

3. Contract Value (base plus options):

4. Contract Award Date:

5. Contract Completion Date:

6. Type of Contract (Check all that apply):

[ ] Fixed Price [ ] Fixed Price Incentive [ ] Fixed Price-Economic Price Adjustment [ ] Award Fee [ ] Cost Plus Fixed Fee [ ] Cost Plus Incentive Fee [ ] Cost Plus Award Fee [ ] ID/IQ [ ] BOA [ ] Requirements [ ] Labor Hour [ ] Time and Materials [ ] Small Business Set-Aside [ ] 8(a) [ ] SBIR [ ] Sealed Bid [ ] Negotiated [ ] Competitive [ ] Non-Competitive

7. Description of Requirement:

8. Name and phone number of evaluator:

9. Company and address of evaluator:

10. Ratings: Summarize contractor performance and circle in the column on the right the rating that corresponds to the contractor performance for each element expanding table or attachments as necessary to complete the rating. Please see attached explanation of the rating scale.

DJM-13-A32-R-0003

PAST PERFORMANCE SURVEY

Attachment 1(G)

Subject Comments Rating

Quality of Service (as defined in contract standards/statement of work). Please address post staffing, post coverage, employee training, employee grooming, and performance violations.

E

VG

S M

US

Schedule Performance (timeliness). Please address timeliness as it relates to staffing, training, and including timely completion of all administrative requirements to the customer’s satisfaction.

S

Costs (demonstrated financial capability in ability to meet payroll and other commitments) Please address ability to meet all overall cost estimates and pricing while meeting all contractual requirements.

S

Small Business Utilization (has the contractor been making a good faith effort to meet the subcontracting goals contained within the plan? (NOTE: The individual completing this questionnaire may need to contact the cognizant contracting officer in order to ascertain whether the contractor is meeting subcontracting goals.)

S

Key Personnel (ability of corporate personnel to administer and manage contract). Please address staffing levels; workflow;

delegations of authority; reporting;

and internal and external communications.

S

Business Relations (history of professional behavior and overall business-like concerns for the interest of the customer) Please address responsiveness, follow through, and customer satisfaction.

S