Past_Performance_Questionaire.pdf

FAR 13.5 TEST PGROGRAM FOR CERTAIN COMMERCIAL ITEMS

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor:________________________________________________________________________

B. Contractor Cage Code of contract was awarded to: _________________________________

C. Contract number: ______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

I. Reasons for differences between initial contract cost and final contract costs:

J. Description of service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: __________________________________________________________ B. Customer or agency description (if applicable): __________________________________________

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other

Commands:

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name: __________________________________________________________________

B. Evaluator's title: ___________________________________________________________________

C. Evaluator's phone/fax number: ________________________________________________________

Number of years evaluator worked on subject contract: ____________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE RATING

E EXCEPTIONAL – The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD - The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY - The contractor’s performance meets contractual requirements. The contractual performance was accomplished some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance doest not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effevtive or were not fully implemented.

U UNSATISFACTORY – Performance doest not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance reflects serious problem(s) for which the contractor corrective actions appear or were ineffictive.

N/A NOT APPLICABLE - Unable to provide a score

QUALITY

Q1. Conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

Q2. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements.

SCHEDULE

T1. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

T2. Ability to successfully respond to emergency and/or surge situations

T3. Adherence to the required delivery schedules.

BUSINESS RELATIONS

B1. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

B2. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)

2. Please discuss every question you evaluated as E (Exceptional), M (Marginal) or U (Unsatisfactory) (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been partially or completely terminated for default or are there any pending terminations?

Yes___ Default___ Pending Terminations___

No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

E V S M U N

What were the contractor’s greastest strengths in the performance of the contract?

What were the contractor’s greastest strengths in the performance of the contract?

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

SECTION 6: OVERALL RATING

Considering all of the information provided above, please rate the contractor's performance overall.

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Mailing Address:

Jason K. Easley

97th Contracting Squadron, LGCB

303 J Ave, Bldg 302

Altus AFB, OK 73523-5132

Or use fax coversheet to:

580 481-5138

DSN 866-5138

or email

Jason.easley@us.af.mil mailto:Jason.easley@us.af.mil