Past_Performance_Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

1.

CONTRACT INFORMATION: Complete the following information on the contractor that provided or is currently providing services for your company.

a.

Contractor’s Name/Address/Phone:

b.

Contract Number: ____________________________________ c.

Program Title: _______________________________________ d.

Contract Type:

( Firm Fixed Price

( Fixed Price Incentive

( Cost Plus Aware Fee

( Cost Plus Incentive Fee

( Other ___________________ e.

Period of Performance: ___________________ f.

Total Contract Dollar Value (as of this date): $_____________________ g.

Brief Description of Contracted Item(s) or Service(s): ___________________________________________________________________________________

2.

When responding to this questionnaire, please use the following definitions as a guide:

Satisfactory (S)

Performance meets contractual requirements and/or exceeds requirements to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Unsatisfactory (U)

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Unknown (N/A) Did not observe performance in this area.

3. Please respond to the following questions regarding the contractor’s past performance. For all ratings, please provide a narrative explaining how the contractor either exceeded your requirement or how the contractor failed to meet your requirement. If the contractor had problems in a specific area, but you determined them to be non-impactive to the mission, please state as such in your narrative remarks.

a. Please rate the contractor’s ability to provide experienced managers and supervisors, with the technical and administrative abilities needed to meet contract requirements recruit and retain quality, qualified personnel.

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Satisfactory

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Unsatisfactory

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Unknown

Narrative: ____________________________________________________________________

b. Please rate the contractor in terms of numbers and quality of personnel and their ability to perform contract requirements.

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Satisfactory

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Unsatisfactory

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c. Please rate the contractor’s ability to provide effective quality control which resulted in a quality finished product.

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Satisfactory

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Unsatisfactory

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d. Please rate the contractor’s ability to identify problems as they occurred. Suggested approaches to problems. Displayed initiative to solve problems. Performed as a "Team" member.

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Satisfactory

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Unsatisfactory

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e. Please rate the contractor’s overall compliance with contract terms and conditions.

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Satisfactory

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Unsatisfactory

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f. Please rate the contractor’s responsiveness to contract changes.

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Satisfactory

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Unsatisfactory

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g. Please rate the contractor's ability to provide submittals in a timely manner. Submittals were well researched and clearly identified the proposed item.

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Satisfactory

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Unsatisfactory

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h. Please rate the contractor’s timely resolution of punch-list items, and warranty calls.

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Satisfactory

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Unsatisfactory

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i. Has the contractor ever been given a cure notice, a show cause notice, a suspension of payment, or had a claim denied?

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Yes (please explain)

No

j. Based on your judgment of the contractor’s performance, would you award the contractor another contract?

Yes (please explain)

No (please explain)

Narrative:

k. Please rate overall customer satisfaction with the contractor's performance.

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Satisfactory

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Unsatisfactory

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4. The following information will help us track the responses received, as well as resolve whatever differences may arise between your perception of the contractor’s performance and the contractor’s perception of their performance.

a.

Evaluator’s Name: __________________________________ b.

Title:

c.

Telephone Number: DSN:

Commercial: ___________________ d.

Organization, Office Symbol, and Address:

e.

Length of involvement in the contract:

f.

Date of questionnaire completion: ____________ Additional Comments: ______________________________________________________________________________

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