Past_Performance_Questionnaire.doc

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

FA5587-14-R-0005

A. GENERAL INFORMATION

Offeror:

Point of Contact:

Address:

Telephone Number:

(The Government enters the following information based on list of references provided by the offeror.)

Project Title and Brief Description of Work:

Contract Name/Number:

$ or £ Amount:

Contract Period or Project Period of Performance:

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

B. CUSTOMER RESPONDENT INFORMATION:

Name of Respondent:

Title:

Company/Organization:

Address:

Telephone Number:

Email Address:

C. EMAIL COMPLETED SURVEY FORM TO: to megan.scioneaux@us.af.mil and eric.schaffstein@us.af.mil

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

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

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.

Once completed this is Source Selection Information -- See FAR 2.101 and 3.104 Place an “X” in the appropriate column using the definitions matrix above.

Note: While these questions are generic and will work as written in many acquisitions, consider them as they relate to each individual acquisition and tailor them as needed and appropriate. Also, when tailoring the form, consider leaving space between questions for comments.

Remarks: (Use as many additional sheets as necessary) **Once completed this is Source Selection Information – see FAR 2.101 and 3.104