Attachment VII-Past Performance Evaluation Document.pdf
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- HSCG23-10-R-DBT000
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Attachment VII Past Performance Evaluation Document
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Attachment VII Past Performance Evaluation Document
CONTRACT DATA SHEET
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:
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).
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