Attachment 4 Past Performance Questionnaire.doc
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- Solicitation number
- HQ0034-12-R-3022
- Issued by
-
DOD Washington Headquarters Service
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Amendment 0001 revises the desired due date on attachment 4 Past Performance Questionnaire.
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PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a vendor evaluation in support of solicitation HQ0034-12-R-3022
Please complete this Questionnaire and email to:
Benjamin.Bryant@whs.mil
Desired Response Date:
Monday May 21, 2012
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:
| 1a: Name of Prime Contractor: |
| 5. CONTRACT VALUE (with options): $ |
6. TYPE OF CONTRACT:
| 7. BRIEF DESCRIPTION OF CONTRACT REQUIREMENTS: |
| (FFP,CPFF, T&M, etc.) |
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 workmanship (e.g., technical, professional, environmental, or safety and health standards).
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.
F. Proficiency Testing Participation Results: Results, if applicable, shall not be older than two years old. (SUBMIT AS ATTACHMENTS)
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