Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Request for solicitation F1B3R31147AC01, closing date 21 September 2011.

Submit completed cover sheet and survey via fax or email to:

97 CONS/LGCA

Attn: Zachary Lee Contract Specialist 308 North 1st Street Altus AFB OK 73523-5003 Email: zachary.lee@altus.af.mil

FAX: 580-481-6041

Do not return this form to the contractor being evaluated. It is desired that this form be submitted to the person identified above, no later than 16 September 2011. Handwritten responses are acceptable. If response is handwritten, please print legibly. If more space is needed for narrative comments, use the back of the survey or attach additional pages. Make sure additional info is identified by the same section and question number. Your time and effort in providing this vitally important information is greatly appreciated.

I. CONTRACT IDENTIFICATION

A. CONTRACTOR _______________________________________________________

B. CONTRACT NO. ______________________________________________________

C. CONTRACT TYPE ____________________________________________________

D. PERIOD OF PERFORMANCE ___________________________________________

E. ACTUAL/ ESTIMATED CONTRACT TOTAL (Include all option periods)

F. DESCRIPTION OF REQUIRMENT ______________________________________

II. IDENTIFICATION OF PARTY PROVIDING INFORMATION

NAME OF ACTIVITY (Include POC /phone #/ email address) mailto:zachary.lee@altus.af.mil�

III. ASSESSMENT OF CONTRACT PERFORMANCE

Please rate the contractor’s performance in the following categories on a scale of 1 to 4 as follows:

1= Exceptional 2= Good 3= Satisfactory 4= Unsatisfactory

Also, please provide an explanation in support of each rating in the space provided.

A. QUALITY OF PERFORMANCE: Please rate/explain the quality of the contractor’s performance; conformance to contract requirements and statement of work; and quality of services.

1 2 3 4 (Circle One)

B. TIMELINESS OF PERFORMANCE: Please rate/explain the timeliness of the contractor’s performance, adherence to contract schedules, completing work efforts on time; and submission of reports and documentation response to requests for information.

1 2 3 4 (Circle One)

C. BUSINESS RELATIONS: Please rate/explain the contractor’s management abilities relative to its use of personnel and subcontractors to meet the requirement, cooperation of personnel and subcontractors during performance, turnover of personnel and subcontractors, ability to solve performance problems.

1 2 3 4 (Circle One)

D. COMMITMENT TO CUSTOMER SATISFACTION: Please rate/explain the contractor’s communications with Government staff, effectiveness of contractor interface with Government staff.

1 2 3 4 (Circle One)

E. Would you recommend selection of this contractor again? YES NO (Circle)

Additional information or comments: _____________________________________________

Thank you for taking the time to complete the questionnaire.

Signature of Person Completing Questionnaire Date

PAST PERFORMANCE QuestionNaire