Attachment_3_-_Past_Performance_Questionnaire.docx

Request for Quote (RFQ) Attachment 3

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and send to Summerlin Walker at summerlin.s.walker.civ@mail.mil

Response Date: Before or by August 8, 2018 at 10:00 P.M. EST

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

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 conditions of its contract.

O E A M U N/O

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

O E A M U N/O

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

O E A M U N/O

E. The Offeror was committed to customer satisfaction

O E A M U N/O

F. Overall Performance Assessment

O E A M U N/O

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