ATTACHMENT F_PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE.docx

ATTACHMENT F

PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE

NAME OF REFERENCE:

TITLE OF CONTRACT:

PERIOD OF PERFORMANCE:

Was consideration or a monetary withhold for non-conforming supplies/services or late deliveries assessed against this contract? YES |_| NO |_|

EXPLANATION

Was/is any part of this contract terminated for default and/or in litigation?

YES |_| NO|_|

Was any warranty work completed on delivered items? YES|_| NO|_|

Did you receive any quality awards in the past three years? YES|_| NO|_|

List Awards:

TIMELINESS

Were all items (including products, services, reports, etc.) delivered within the original contract schedule? YES|_| NO|_|

EXPLANATION

COST

For Cost Type Contracts

Was the original contract estimated cost met? YES|_| NO|_|

If the estimated cost was not met, what was the positive/negative percentage of change?

OTHER PERTINENT INFORMATION

DESCRIBE ANY CORRECTIVE ACTION(S) INITIATED TO SOLVE ANY OF THE ABOVE-DESCRIBED PROBLEMS/DEFICIENCIES ON THIS CONTRACT. DISCUSS THE SUCCESS OF THE CORRECTIVE ACTION(S) TAKEN.

OFFEROR'S NAME: __________________________________________