Past performance Form.docx

ATTACHMENT E

CONTRACTOR PERFORMANCE INFORMATION

Contractor Name and Address (Identify Division)

1. Contract Number:

2. Type of Contract:

3. Contract Value (Current plus any unexercised options): $

(Please correct the above as needed.)

4. Period of Performance (including any option periods):

5. Description of Requirement:

6. Ratings. Summarize contractor performance and circle or type in the number below that corresponds to the performance rating for each category. Please see the attachment, which explains the rating scale.

Quality:

Comments:

Problem Resolution:

Comments:

Cost Control:

Timeliness:

Business Relations:

Customer Service:

7. Total score:

U.S. Department of Education

Evaluated by:

Your Agency/Organization______________________________________ Date ___________

(In accordance with the Federal Acquisition Streamlining Act, the following information will not be released to the contractor.)

Your Name and Title _________________________________________

Your Telephone number _________________________

Signature _____________________________________________

E-mail address _______________________

Please return this form to the following address:

U.S. Department of Education Contracts and Acquisitions Management Attn: Zilphia Wright PCP Room 7123 550 12th Street SW Washington, DC 20202-4230

Or e-mail to: Zilphia.Wright@ed.gov Or fax to: 202-245-6292 Attn: Zilphia Wright.

RFP #: PESARD

SOURCE SELECTION INFORMATION—SEE FAR 3.104

Information entered on this form will be used in source selection decisions and is protected under subsection 3.104 of the Federal Acquisition Regulation. Do not disclose information entered on this form to the contractor or to any other person except as authorized by the Department of Education contracting officer.

Supplementary Questions

To assist the Department of Education contracting officer, we would greatly appreciate your taking the time to answer the following questions, if any, related to the contractor’s past performance: N/A

Based on the rating area elements presented below and the rating guidelines on the back of this sheet, please evaluate contractor performance in each of the rating areas. On the “Contractor Performance Information” form, circle (or type in the “Comments:” area) the rating from 0 to 4 that most closely matches your evaluation of the contractor’s performance. Please add written comments for each rating. If you wish, you may attach additional comments or information. We would also appreciate your answers to the specific questions, if any, on the back of the form. Please return the form to the address indicated on the back of the form. Thank you for your time and your cooperation.

The Department of Education will use the information from this form to evaluate offerors competing for contract awards. We may release the information from this form to the contractor during negotiations or debriefings. If we release information from this form, we will not release your name to the contractor.

Elements within Each Rating Area

Quality of Product or Service

Problem Resolution

Cost Control

Timeliness of Performance

Business Relations

Customer Service

Rating Guidelines

Quality of Product or Service

Problem Resolution

Cost Control

Timeliness of Performance

Business Relations

4 - Excellent

Customer Service Highly effective, proactive business practices focused on customer support.