Past Performance Questionnaire.rtf

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Project Title and Brief Description of Work:

Contract Number: Dollar Amount:

Contract Period or Dates of Performance:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent:

Title:

Address:

Telephone Number: Fax Number:

Email Address:

C. MAIL, EMAIL, OR FAX COMPLETED SURVEY FORM TO:

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

E G S M U N Exceptional Good Satisfactory Marginal Unsatisfactory Neutral Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

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 or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

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 a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor:

E G S M U N 1.

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2.

Demonstrated ability to hire, maintain, and replace, if necessary, a sufficient number of qualified personnel during the contract period.

3.

Delegated authority to project managers and supervisors commensurate with contract requirements.

4.

Home office participated in solving significant local problems.

5.

Followed approved quality control plan.

6.

Provided effective quality control and/or inspection procedures to meet contract requirements.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

7.

Corrected deficiencies in timely manner and pursuant to their quality control procedures.

8.

Provided timely resolution of contract discrepancies.

9.

Identified problems as they occurred.

10.

Suggested alternative approaches to problems.

11.

Displayed initiative to solve problems.

12.

Was responsive to contract changes.

13.

Provided adequate project supervision.

14.

Paid subcontractors/suppliers in a timely manner.

15.

Utilized dependable and adequate amount of equipment/personnel to meet contract requirements.

16.

Was responsive to customer complaints/requests.

17.

Provided accurate and complete line item cost proposals including all aspects of work required for each task.

18.

Cooperated with Government personnel after award.

19.

Was the contractor's performance in compliance with all local, state, and federal laws and regulations?

20.

Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

21.

Would you award another contract to this contractor? If not, explain in “remarks.”

YES/NO

22.

Is the contractor rated in CPARS?

YES/NO

23.

How would you rate the contractor's overall performance?

E G S M U N

Remarks: