past_performance_questionnaire.doc
DOC document 56 KB Posted
- Attached to
- Amendment 08 September 2016
- Solicitation number
- HQ0034-16-R-0210
- Issued by
-
DOD Washington Headquarters Service
About this file
Past Performance Questionnaire
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PAST PERFORMANCE QUESTIONNAIRE
Solicitation# HQ0034-16+-R-0210 Please complete this Questionnaire and e-mail directly to the Contract Specialist, Email: dimitria.h.antonopoulos.civ@mail.mil
We are currently in the process of preparing our proposal for the Washington Headquarters Services (WHS) Solicitation Number HQ0034-16-R-0210. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.
Please complete this Questionnaire and e-mail directly to the Contracts Specialist at dimitria.h.antonopoulos.civ@mail.mil Questionnaire is due to the Contracts Specialist no later than Septemeber 9, 2016 at 5:00 PM Eastern Time. Please submit this questionnaire via email from your corporate email account.
NAME OF OFFEROR:
Phone:
Fax:
E-Mail:
I. Current or Historical Contract Information
CONTRACT REFERENCED:
1. Contract or Identifying Number: ________________________________________________
2. Contract Value: _____________________________________________________________
3. Period of Performance: ______________________________________________________________________________
4. Brief description of items provided:
5. Name of Person Completing Questionnaire: _______________________________________ Agency/Company:
Title: __________________________________ Phone: _____________________________
E-mail: _____________________________________________________________________ II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.
Evaluation Definitions – The following definitions should be used in the assessment of Contractor performance.
| EXCEPTIONAL |
| Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns. |
| VERY GOOD |
| Performance EXCEEDS SOME contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective. |
| SATISFACTORY |
| Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective. |
| MARGINAL |
| Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective. |
| UNSATISFACTORY |
| Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective. |
| NOT APPLICABLE (N/A) |
| Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment. |
Past Performance Evaluation
Question 1. Performance What is your assessment of the Contractor’s ability to meet your requirements?
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| N/A |
Performance
Comments, if any.
Questions 2 and 3. Timeliness
What is your assessment of the Contractor’s ability to provide products in a timely manner?
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| N/A |
Timeliness
Ability to Resolve Timeliness Problems
Question 4. Quality of Work What is your assessment of the Contractor’s ability to meet requirements of shipping (including packing, marking, etc) and the overall quality of the delivery?
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| N/A |
Quality of Work
Question 5. Overall Rating of Contractor’s performance What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?
| Exceptional |
| Very Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
General Comments:
PAGE
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