Attachment_3_-_Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and send to Andrea Montgomery @ andrea.m.montgomery.civ@mail.mil.

Response Date: Before or by JULY 14, 2017 The information provided on this form is SOURCE SELECTION INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1. A. CONTRACTOR NAME & ADDRESS: 2. CONTRACT/SUBCONTRACT NO.:

3. CONTRACT/SUBCONTRACT INITIATION DATE:

4. COMPLETION DATE:

1.B. NAME OF PRIME OFFEROR, if this questionnaire is for a team member:

5. CONTRACT/SUBCONTRACT VALUE (with options):

6. TYPE OF CONTRACT (Fixed Price, GMP, FPI, etc.):

7. PROJECT TITLE, LOCATION, AND DESCRIPTION (INCLUDING TOTAL CONSTRUCTION VALUE):

Please add a continuation page if additional space is 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:

9. Please circle the response code for each topic (A – F) that best reflects your experience with this contractor.

O = Outstanding

E = Excellent

A = Acceptable

M = Marginal

U = Unacceptable

N/O = Not Observed

A. Offeror was capable, efficient, and effective while working for your agency or company.

O E A M U N/O

B. The Offeror’s performance was in conformance to the terms and conditioins of its contract.

C. Assess the contractor’s ability to fulfill the performance requirements of the contract.

D. The Offeror was able to hire and retain qualified personnel to the satisfaction of the customer.

E. The Offeror was committed to customer satisfaction

F. Overall Performance Assessment

10. If this was an award fee contract, what was the average award fee % earned?

mailto:andrea.m.montgomery.civ@mail.mil