Contract_Performance_Questionnaire_2.docx

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Attached to
Gymnasium Floor Resurfacing Federal contract opportunity
Solicitation number
DTMA9117R00005
Issued by
Department of Transportation Maritime Administration

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Past Performance Questionnaire Page | 1

PAST PERFORMANCE QUESTIONNAIRE

CONTRACT/PROJECT INFORMATION (Contractor/Vendor only completes section 1-4)

1. Client Information:

Address:

Phone Number:

Fax Number:

Point of Contact:

Contact Phone Number

2. Work Performed as: (Check all that apply)-[ ] Prime Contractor [ ]Sub Contractor [ ] Joint Venture [ ]Other (Explain)

Comments:

3. Contract/Project Name:

Contract/Project Number (If Applicable):

Location:

Period of Performance:

Amount:

4. Contract/Project Description:

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

ASSESSMENT RATINGS
DEFINITION
Exceptional/High Confidence
Based on the offeror's performance record, essentially no doubt exists that the offeror will successfully perform the required effort.
Very Good/Significant Confidence
Based on the offeror's performance record, little doubt exists that the offeror will successfully perform the required effort.
Neutral/Satisfactory Confidence
Based on the offeror's performance record, some doubt exists that the offeror will successfully perform the required effort or no performance record identifiable (see FAR 15.305(a) (2) (iii) and (iv)).
Marginal/Little Confidence
Based on the offeror's performance record, significant doubt exists that the offeror will successfully perform the required effort. Changes to the offeror's existing processes may be necessary in order to achieve contract requirements.
Unsatisfactory/No Confidence
Based on the offeror's performance record, extreme doubt exists that the offeror will successfully perform the required effort.

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

1. Ability to meet quality standards specified for technical performance
E V N M U

2. Quality of work E V N M U

3. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports
E V N M U
4. Effectiveness of on-site management, including management of subcontractors
E V N M U
5. Business ethics/behavior
E V N M U
6. Timeliness/effectiveness of contract problem resolution with extensive customer guidance
E V N M U
7. Cost Control
E V N M U
8. Ability to successfully respond to emergency situations
E V N M U
9. Responsiveness regarding safety issues
E V N M U
10. Timeliness of performance
E V N M U
11. Would you select the firm again?
Y N
12. In summary, provide an overall rating for the work performed by this contractor
E V N M U

Any additional comments related to the contractor’s performance

Release of Information: This Contractor Performance Report may be used to support future award decisions, and will be treated as source selection information in accordance with FAR 3.104-4(k)(1)(x) and 42.1503(b). The completed report shall not be released to other than Government personnel and the contractor whose performance is being evaluated during the period the information is being used to provide source selection information.

File details come from the government source that posted it. Updated .