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HSBP1013R0017- Attachment 5 - Parst Performance Questionaire

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ATTACHMENT 5

Section L TAB C—PAST PERFORMANCE QUESTIONNAIRE

Agency/Owner Identification

Name (evaluator’s organization):

Respondents Name/Phone Number:

Contract Information

Contractor (company being evaluated):

Contract Number:

Contract Type

FFP

CPIF

CPAF

CPFF

T&M

Other

Competitive:

Yes

No

Follow-On:

Yes

No

Period Of Performance:

Initial Contract Value:

Current Contract Value:

Has this contract been partially or completely terminated for default or convenience?

No

Yes

Default

Convenience

If yes, please explain.

Brief Description of Product or Service Provided:

PAST PERFORMANCE QUESTIONAIRE (continued)

Please check the box next to the description, which best describes the Contractor’s performance on this contract. Use blank area below questions for any comments.

1. To what extent did the Contractor adhere to contract delivery schedules?

Always met schedule

Occasionally had delays of less than 30 days

Experienced one or more delay of greater than 30 days

Never met schedule

2. To what extent did the Contractor submit required reports and documentation in a timely manner?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

3. To what extent were the Contractor's reports and documentation accurate and complete?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

4. To what extent was the Contractor able to solve contract performance problems without extensive guidance from government counterparts?

Considerably successful

Generally successful

Little success

No success

5. Did the Contractor save/cost the Government/Owner money or provide other benefits as a result of innovative work applications?

Displayed considerable initiative

Displayed some initiative

Displayed little

Displayed no initiative

6. Did the Contractor commit adequate resources (people, materials, equipment, funding) in a timely fashion to meet contract requirement and successfully solve problems?

Provided abundant resources

Provided sufficient resources

Provided minimal resources

Provided insufficient resources

7. To what extent did the Contractor submit required proposals and/or responses in a timely manner?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

8. To what extent did the Contractor’s products fulfill contract requirements and customer expectations?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

9. To what extent did the Contractor’s performance of services fulfill contract requirements and customer expectations?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

10. Was the Contractor cooperative and responsive to changing needs of the customer?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

11. To what extent was the Contractor's problem tracking/reporting documentation timely, accurate, and of appropriate content?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

12. To what extent was the Contractor effective in interfacing with the Government’s staff?

Extremely Effective

Generally effective

Generally ineffective

Extremely ineffective

13. Were any instances of required re-work due to lack of quality control by the Contractor?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

14. To what extent did the Contractor coordinate, integrate, and provide for effective subcontractor management?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

15. Were the required Small Business utilization goals met?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

16. To what extent did the Contractor demonstrate sensitivity to environmental compliance?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

17. To what extent did the Contractor meet repair/response times required by the contract?

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

Not applicable

18. To what extent did the Contractor submit invoices in a timely and accurate manner?

Always

Most of the time

Some of the time

Seldom

19. To what extent did the invoices provide sufficient detail so that the Government/Owner could accurately evaluate the cost and performance progress?

Always

Most of the time

Some of the time

Seldom

20. To what extent did the Contractor deliver the product at the original agreed to price?

Always

Most of the time

Some of the time

Seldom

Are there any additional comments the Government should consider regarding this Contractor’s performance under your contract?

� Contract Types: FFP = Firm Fixed Price; CPIF = Cost Plus Incentive Fee; CPAF = Cost Plus Award Fee; �CPFF = Cost Plus Fixed Fee; T&M = Time and Materials

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