Amendment 2 - Attachment 5 - Past Performance Questionnaire.xls
XLS spreadsheet 35 KB Posted
- Attached to
- Post Award Information for D2T1 Awardees Federal contract opportunity
- Solicitation number
- HSCG23-10-R-TABS00
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Amendment 2 - Attachment 5 - Past Performance Questionnaire
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Sheet1
| TABSS Solicitation, Amendment 2 - Attachment 5 - Past Performance Questionnaire | |||
| CONTRACTOR FILLS OUT THESE BLOCKS | |||
| REFERENCE FILLS OUT THESE BLOCKS | |||
| 1. Name/Address of Contractor: | |||
| Company Name: | |||
| Division Name: | |||
| Street Address: | |||
| City, State, Zip Code: | |||
| Province/Country: | |||
| CAGE Code: | |||
| DUNS+4 Number: | |||
| FSC: | |||
| NAICS Code: | |||
| 2. Period of Performance Being Assessed: | |||
| 3. Contract Number: | |||
| 4. Contracting Office: | |||
| 5. Location of Contract Performance: | |||
| 6a. Contracting Officer: | |||
| 6b. Phone Number: | |||
| 7a. Contract Award Date: | |||
| 7b. Contract Effective Date: | |||
| 8. Contract Completion Date: | |||
| 9. Awarded Dollar Value: | |||
| 10. Current Contract Dollar Value: | |||
| 11. _ _Competitive ___Non-Competitive | |||
| 12. Contract Type: ___FFP ___FPI ___FPR ___CPFF ___CPIF ___CPAF _ _ OTHER MIXED/OTHER: | |||
| 13. Key Subcontractors and Effort Performed: | |||
| Subcontractor name and CAGE: | |||
| 14. Program Title: | |||
| 15. Contract Effort Description: | |||
| Small Business Utilization | |||
| Does this contract include a subcontracting plan? | |||
| Is small business subcontracting under this contract included in a comprehensive small business subcontracting plan? | |||
| Is small business subcontracting under this contract included in a commercial small business subcontracting plan? | |||
| Date of last Individual Subcontracting Report (ISR) / Summary Subcontracting Report (SSR): | |||
| 16. Evaluate the Following Areas: | Past Rating | Current Rating | Trend |
| Exceptional, Very Good, Satisfactory, Marginal or Unsatisfactory | Exceptional, Very Good, Satisfactory, Marginal or Unsatisfactory | N/A, + or - | |
| a. Quality of Product or Service | |||
| b. Schedule | |||
| c. Cost Control | |||
| d. Business Relations | |||
| e. Management of Key Personnel | |||
| f. Utilization of Small Business | |||
| g. Other Areas: | |||
| (1): | |||
| (2): | |||
| (3): | |||
| (4): | |||
| (5): | |||
| (6): | |||
| (7): | |||
| (8): | |||
| 17. Assessing Official Narrative: | |||
| QUALITY OF PRODUCT OR SERVICE: | |||
| SCHEDULE: | |||
| COST CONTROL: | |||
| BUSINESS RELATIONS: | |||
| MANAGEMENT OF KEY PERSONNEL: | |||
| UTILIZATION OF SMALL BUSINESS: | |||
| OTHER AREAS: | |||
| (1) | |||
| (2) | |||
| (3) | |||
| (4) | |||
| RECOMMENDATION: Given what I know today about the Contractor's ability to execute what they promised in their proposal, I [FILL IN THE BLANK FROM THE CHOICES BELOW*] award to them today given that I had a choice. | |||
| * - Definitely Would Not, Probably Would Not, Might Not, Might, Probably Would, Definitely Would | |||
| Assessing Official Name | |||
| Assessing Official Title | |||
| Assessing Official Phone # | |||
| Assessing Official Email Address |
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