Past Performance.pdf

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a vendor evaluation for solicitation HQ0034-09-R-3004 Please complete this Questionnaire and mail or send by facsimile [FAX (703) 696-4164] to:

WHS Acquisition & Procurement Office Attn: Ms. Kristin S. Fuller

1777 North Kent Street, Suite 12063 Arlington, VA 22209

Desired Response Date:

June 12, 2009

When complete, the information on this form is SOURCE SELECTION INFORMATION (FAR 2.101 & 3.104) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1. CONTRACTOR NAME & ADDRESS:

2. CONTRACT NO.:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options):

1a: NAME OF PRIME CONTRACTOR (if this questionnaire is for a team member on the

BIENNIAL REVIEW Support project):

6. TYPE OF CONTRACT: Firm Fixed Price

(FFP,CPFF, T&M, etc.)

7. BRIEF DESCRIPTION OF CONTRACT REQUIREMENTS:

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR'S NAME, POSITION ( Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

A. Quality of Products and Services – Please provide a statement regarding the contractor’s conformance to contract requirements, specifications, and standards of good orkmanship (e.g., technical, professional, environmental, or safety and health standards). w

B. Performance – Please provide a statement regarding the contractor’s performance for the project.

C. Schedule – Please provide a statement regarding the timeliness of contractor against the schedule of deliverables.

D. Customer Satisfaction – Please provide a statement regarding the contractor’s responsiveness to customer needs.

E. Area for Improvement – If you had to describe one area for improvement, what would it be? Please state the significance.

TO BE COMPLETED BY OFFEROR