Past Performance Questionnaire.docx

Past Performance Questionnaire* Note: Completed Questionnaire shall be considered confidential information and may not be seen or reviewed by the Contractor/Offeror. This form shall be sent by prospective offeror’s to two (2) references and shall be filled out completely by the reviewer. The form shall be signed and placed in a sealed envelope. That envelope shall be then placed in a separate envelope and returned to the offeror. The offeror shall include the sealed envelope containing the reference with their Technical Proposal.

1. Contractor Identification (To be completed by offeror and provided to customer for reference) Name of offeror being evaluated:__________________________________________________________________ Project Number/Title:___________________________________________________________________________ Project Location:_______________________________________________________________________________ Project Description:_____________________________________________________________________________ Number of employees under project:_______________________________________________________________ Project Dollar Amount: _________________________________________________________________________ Dates of Project:_______________________________________________________________________________ Project Manager:_______________________________________________________________________________

2. Respondent Identification (To be completed by reviewer) Name of Evaluator:_____________________________________________________________________________ Your Relation to project:_________________________________________________________________________ Company Name:_______________________________________________________________________________ Phone Number:________________________________________________________________________________ Email Address:________________________________________________________________________________

Signature of Reviewer:_________________________________________________________________________

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Past Performance Questionnaire (continued)

3. Rating of Offeror Please provide your rating on the following factors, by either identifying the offeror’s performance as either satisfactory or unsatisfactory by checking the appropriate box with an “X or check mark”. “Satisfactory” is defined as the offeror meeting the contractual requirements with only minor or no problems and corrective action was taken by the contractor to fix/meet the standard of performance. “Unsatisfactory” is defined as the offeror’s performance did not meet most of the contractual requirements and they failed to correct deficiencies appropriately or timely.

Evaluation Factors

Rate the offeror’s overall quality of service provided to you for the subject project.

Rate the offeror’s communication and responsiveness to your needs under the subject project.

Rate the offeror’s ability to recruit qualified employees for the project.

Rate the offeror’s ability to retain qualified employees for the project.

Rate the offeror’s professionalism, ease of doing business and overall cooperation throughout the life of the project.

Rate the offeror’s ability to quickly and pro-actively identify issues within your project.

Rate the offeror’s accuracy and timeliness in regard to delivery of submittals required under the project.

4. Narrative Summary Please indicate in writing any additional comments you have of the offeror regarding the strengths or weaknesses of their performance, or any additional thoughts regarding the offeror.