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Past Performance Questionnaire
PAST PERFORMANCE QUESTIONNAIRE
CONTRACT INFORMATION
(Contractor to Complete Blocks 1 to 4)
1. Contractor Information:
| Firm Name: | CAGE Code: |
| Address: | Unique Entity Identifier (i.e. DUNS): |
| Name: | Phone Number: |
| Title: | Email Address: |
2. Work Performed as:
|_| Prime Contractor |_| Subcontractor |_| Joint Venture |_| Other (Explain)
| Percentage of Work Performed: |
| If Subcontractor, who was the Prime Contractor (Name / Phone Number): |
3. Contract Information:
Contract Number: Delivery / Task Order Number (if applicable):
Contract Type: |_| Firm-Fixed-Price |_| Cost Reimbursement |_| Other (Please specify):
| Contract Title: |
| Contract Location: |
| Award Date (MM/DD/YY): |
| Contract Completion Date (at Award) (MM/DD/YY): |
| Contract Completion Date (Actual) (MM/DD/YY): |
| Explain Date Differences: |
| Contract Price (at Award): | $ |
| Contract Price (Actual, Inclusive of Modifications): | $ |
| Explain Price Differences: | |
4. Project Description:
How is this project similar in scope to the work required within the solicitation?
REFERENCE INFORMATION
(Reference to Complete Blocks 5 to 8 and Sections 1 to 7 of Questionnaire)
5. Reference Information:
| Name: | Phone Number: |
| Title: | Email Address: |
6. Describe the Reference’s Role in the Project:
7. Date Questionnaire Completed (MM/DD/YY):
8. Reference’s Signature:
ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT
YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
| (E) Exceptional |
| Performance meets contractual requirements and exceeds many requirements to the Government / Owner’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 was highly effective. |
| An Exceptional rating is appropriate when the contractor successfully performed multiple significant events that were of benefit to the Government / Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified. |
| (VG) Very Good |
| Performance meets contractual requirements and exceeds some requirements to the Government’s / Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| A Very Good rating is appropriate when the contractor successfully performed a significant event that was a benefit to the Government / Owner. There should have been no significant weaknesses identified. |
| (S) Satisfactory |
| Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per general policy, the contractor shall not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract. |
| (M) Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented. |
| A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government / Owner. |
| (U) Unsatisfactory |
| 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. |
| An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government / Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. |
| (N) Not Applicable |
| No information or did not apply to your contract. |
| Rating will be neither positive nor negative. |
TO BE COMPLETED BY CLIENT
PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS
YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
1. QUALITY:
| a) | Quality of technical data / report preparation efforts. | | | | |
| E | VG | S | M | U | N |
| b) | Ability to meet quality standards specified for technical performance. | | | | |
| E | VG | S | M | U | N |
| c) | Timeliness / effectiveness of contract problem resolution without extensive customer guidance. | | | | | |
| E | | VG | S | M | U | N |
| d) | Adequacy / effectiveness of quality control program. | | | | | |
| E | | VG | S | M | U | N |
2. SCHEDULE / TIMELINESS OF PERFORMANCE:
| a) | Compliance with contract delivery / completion schedules including any significant intermediate milestones. | | | | | |
| E | | VG | S | M | U | N |
| b) | Contractor’s use of available resources to accomplish tasks identified in the contract. | | | | | |
| E | | VG | S | M | U | N |
3. CUSTOMER SATISFACTION:
| a) | To what extent were the end users satisfied with the project? | | | | | |
| E | | VG | S | M | U | N |
| b) | Contractor was reasonable and cooperative in dealing with your staff, including the ability to successfully resolve disagreements / disputes and responsiveness to administrative reports. | | | | | |
| E | | VG | S | M | U | N |
| c) | To what extent was the contractor cooperative, businesslike and concerned with the interests of the customer? | | | | | |
| E | | VG | S | M | U | N |
| d) | Overall customer satisfaction. | | | | | |
| E | | VG | S | M | U | N |
4. MANAGEMENT / PERSONNEL / LABOR:
| a) | Effectiveness of onsite management, including management of subcontractors, suppliers, materials and / or labor force. | | | | | |
| E | | VG | S | M | U | N |
| b) | Ability to hire, apply and retain a qualified workforce for this effort. | | | | | |
| E | | VG | S | M | U | N |
| c) | Knowledge / expertise demonstrated by contractor personnel. | | | | | |
| E | | VG | S | M | U | N |
| d) | Ability to simultaneously manage multiple projects with multiple disciplines. | | | | | |
| E | | VG | S | M | U | N |
| e) | Ability to assimilate and incorporate changes in requirements and / or priority, including planning, execution and response to Government changes. | | | | | |
| E | | VG | S | M | U | N |
| f) | Effectiveness of overall management, including ability to effectively lead, manage and control the program. | | | | | |
| E | | VG | S | M | U | N |
5. COST / FINANCIAL MANAGEMENT:
| a) | Ability to meet the terms and conditions within the contractually agreed price(s). | | | | | |
| E | | VG | S | M | U | N |
| b) | Contractor proposed innovative alternative methods / processes that reduced cost, improved maintainability or other factors that benefitted the client. | | | | | |
| E | | VG | S | M | U | N |
| c) | If this is / was a Government contract, has / was this contract been partially or completely terminated for default or convenience or are there any pending terminations? If ‘Yes,’ in the remarks section, indicate if show cause or cure notices were issued. | |
| Yes | | No |
| d) | Have there been any indications that the contractor has had any financial problems? If ‘Yes,’ provide rationale in the remarks section. | |
| Yes | | No |
6. SAFETY / SECURITY:
| a) | To what extent was the contractor able to maintain an environment of safety, adhere to is approved safety plan and respond to safety issues? This includes following user rules, regulations and requirements regarding housekeeping, safety, correction of noted deficiencies, and so on. | | | | | |
| E | | VG | S | M | U | N |
| b) | Complied with all security requirements for the project and personnel security requirements. | | | | | |
| E | | VG | S | M | U | N |
7. GENERAL:
| a) | Ability to successfully respond to emergency and / or surge situations, including notifying appropriate Government / Owner personnel in a timely manner, regarding urgent contractual issues. | | | | | |
| E | | VG | S | M | U | N |
| b) | Compliance with contractual terms / provisions. Explain in the remarks section. | | | | | |
| E | | VG | S | M | U | N |
| c) | Would you hire or work with this firm again? Explain in the remarks section. | |
| Yes | | No |
| d) | In summary, provide an overall rating for the work performed by this contractor. | | | | | |
| E | | VG | S | M | U | N |
Remarks: Please provide responses to the questions above (if applicable) and / or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies or other comments which may assist our office in evaluating performance risk. Attach additional pages if necessary.
Remarks (Continued):
