Questionnaire.pdf

HSCG23-13-R-MSF059

Submit Completed Questionnaires to: Camille Tongco Email: Camille.Tongco@uscg.mil

PAST PERFORMANCE QUESTIONNAIRE

Contractor’s Name: Customer’s Name:

Contract Number: Contract Type:

Period of Performance: Contract Value: $

Description of Requirement:

See the below table for the adjectival ratings and definitions for the past performance evaluation:

Rating Definition Exceptional One or more examples where performance on the subject contract significantly exceeded requirements to the Government’s benefit.

Very Good One or more examples where performance on the subject contract met requirements and exceeded some to the Government’s benefit.

Satisfactory Performance on the subject contract met requirements.

Marginal Performance on the subject contract did not meet some requirements.

Unsatisfactory One or more examples where performance on the subject contract significantly failed to meet requirements due to fault of contractor.

HSCG23-13-R-MSF059

Submit Completed Questionnaires to: Camille Tongco Email: Camille.Tongco@uscg.mil

PAST PERFORMANCE QUESTIONNAIRE

Quality of Product or Service:

Remarks:

Timeliness of Performance:

Business Relations:

If subcontracts were involved, rate Contractor’s performance in managing them:

Was the contractor committed to customer satisfaction?: Check One: Yes No

Would you recommend the selection of this firm?: Check One: Yes No