Past_Performance_Survey_doc.docx

1. Customer Name:

1. Customer Phone/E-mail:

1. Customer Agency/Company:

1. Contractor’s Name:

1. Project Name:

1. Project Period of Performance:

1. Total Contract Value (base + option periods):

Please rate questions 8-13 on the following scale:

1 = Unsatisfactory, 5= Excellent, N/A = Not Applicable:

(5) Excellent Performance

(4) Good Performance

(3) Satisfactory Performance

(2) Fair Performance

(1) Unsatisfactory Performance

(N/A) Not Applicable

1. How would you rate the Contractor's record of performing according to the statement of work including standards of good workmanship (e.g., compliance with contract requirements, accuracy of reports, effectiveness of personnel, technical excellence)?

Score:

Additional Comments:

1. How would you rate the Contractor's record of controlling and forecasting costs (e.g., forecasting and controlling target costs, accurate and complete billings, cost efficiencies)?

Additional Comments:

1. How would you rate the Contractor's adherence to contract schedules including the administrative aspects of performance (e.g., met interim milestones, reliability, responsive to technical direction, met delivery schedule)?

Additional Comments:

1. How would you rate the Contractor's reputation for reasonable and cooperative conduct and commitment to customer satisfaction (e.g., effective management, reasonable conduct, flexibility, notification of problems)?

Additional Comments:

1. How would you rate the Contractor's business-like concern for the interest of the customer (e.g., history of staff turnover, responsive to contract requirements, pro-active)?

Additional Comments:

1. How would you rate your overall experience with the contractor?

Additional Comments:

1. Would you consider using this Contractor again?

|_| Yes |_| No

1. Additional Comments (e.g., information on problems encountered on the contract and the Contractor's corrective actions)?