Attachment VI Past Performance Evaluation Document.docx
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- HSCG23-10-R-DBT000
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Attachment VI Past Performance Evaluation Document (Word Format)
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Attachment VI Past Performance Evaluation Document
CONTRACT DATA SHEET
SECTION A: TO BE COMPLETED BY CONTRACTOR
CONTRACTOR NAME____________________________________________________
(Complete one Contract Data Sheet per reference.)
| Contract Number: |
| Prime or Subcontractor: |
| Dollar Amount: |
| Date Completed: |
| Contract Type: |
| Fixed Price___ Cost Reimbursement ___ Other (Specify) __________ |
Item/Service Description:
Contract Quantity/Period of Performance:
Customer Activity:
Customer POC (Person who can verify data):
Address:
Phone:
FAX:
E-Mail:
SECTION B: TO BE COMPLETED BY GOVERNMENT
PERFORMANCE INFORMATION
| YES |
| NO |
| 1 |
| Were all supplies/services delivered within the original contract schedule? |
| 2 |
| Did all delivered supplies/services comply with the contract specifications/ statement of work? |
| 3 |
| Did any of the delivered supplies/services require replacement, modification or rework in order to be acceptable? |
| 4 |
| Were any modifications issued relaxing the contract specifications/delivery requirements? |
| 5 |
| Was any part of this contract terminated for default or cause? |
| 6 |
| Did you receive any quality awards in the past three years? |
| 7 |
| If applicable, describe any corrective action(s) initiated to solve any problems/deficiencies on this contract. Discuss the success of the corrective action(s) taken. |
| 8 |
| Overall Past Performance Rating (Check only one Box): |
No rating. The contractor has no relevant past performance (Color Code: White).
Superior. One or more examples where past performance significantly exceeded requirements (Color Code: Blue).
Satisfactory. Past performance met requirements (Color Code: Green).
Marginal. One or more examples where past performance failed to meet requirements due to fault of contractor. (Color Code: Yellow)
Unsatisfactory. One or more examples where past performance significantly failed to meet requirements due to fault of contractor (Color Code: Red).
File details come from the government source that posted it. Updated .