PAST_PERFORMANCE_QUESTIONNAIRE_FORM-Fillable.pdf

PAST PERFORMANCE QUESTIONNAIRE

BUSINESS & ECONOMIC DEVELOPMENT TRAINING

H92239-16-T-0002

SECTION 1: CONTRACT IDENTIFICATION

(to be completed prior to mailing or faxing to the respondent)

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SENSITIVE AND SHALL

NOT BE RELEASED TO THE OFFEROR.

A. Contractor's Name: ________________________________ B. Contract number: __________________________________ C. Contractor's Role in the contract identified above: Prime: Yes _____ No _____

Subcontractor to Prime? If Yes, who?______________ D. Cage Code: _________________________________ 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

(to be completed prior to mailing or faxing to the respondent)

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

(to be completed by the respondent)

A. Evaluator's name: __________________________________________________________________________ B. Evaluator's title/role: ________________________________________________________________________ C. Evaluator's phone/fax number: ________________________________________________________________ D. Number of years evaluator worked on subject contract: ____________________________________________

SECTION 4: EVALUATION

(to be completed by the respondent)

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 LEVEL

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

REQUIRED FOR ADMINISTRATIVE PURPOSES:

SELECT WHICH APPLIES: _____PRIME OFFEROR

_____SUBCONTRACTOR TO__________________(ENTER PRIME OFFEROR)

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

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

Program Management E V S M U N/A

The Contractor is committed to customer satisfaction.

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

Timeliness/effectiveness of contract problem resolution without extensive customer guidance

Understand/complied with customer objectives and technical requirements and regulations

Contractor implemented responsive/flexible processes to improve quality and timeliness of support

Effectiveness in scheduling and maintaining instructor ratios

Provided all reports required by the contract in a timely manner.

Identified problems in advance and when necessary, took positive and effective corrective actions.

Met the terms of the contract and within the contractual price.

Select one rating which most accurately describes the contractor’s overall performance on your contract.

1. Please discuss each and every response for which you indicated a M (Marginal) or US (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

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

Yes____ Default____ Convenience____ Pending Terminations____ No ____ If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc)._________________________________________________________________________________________

SECTION 5: NARRATIVE SUMMARY

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

Please provide any additional comments concerning this contractor’s performance in a separate document.

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

RETURN YOUR COMPLETED QUESTIONNAIRE TO, HQ UNITED STATES ARMY SPECIAL OPERATION

COMMAND, DCSC, BLDG E2929 DESERT STORM DRIVE, , ATTN: BRITTANY C. BLACK, EMAIL:

brittany.c.black@soc.mil AND CC jennifer.payne@soc.mil