PastPerformance.doc

ATTACHMENT

The U. S. Coast Guard ELC, Contracting Office, Baltimore, MD is conducting a competitive acquisition. The offeror has identified you as a reference to validate the offeror’s past performance.

Please complete the following questionnaire to assist our evaluation of the contractor’s past performance and fax it to Patricia Dobbins (410) 762-6056, or email completed questionnaire to: Patricia.L.Dobbins@uscg.mil.

Name of Contractor being evaluated:

Contract No.

Description

Total contract cost:

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

Considerably surpassed/exceeded delivery schedules

Met delivery schedule (no unexcusable delays)

Minimal delays (did not impact achievement of contract requirements) [ ]

Extensive unexcused delays

COMMMENTS:__________________________________________________________

2 To what extent was the contractor able to solve contract performance problems without extensive guidance from the government?

Completely successful [ ]

Generally successful [ ]

Little success [ ]

No success [ ]

3. To what extent did the contractor display initiative in meeting requirements?

Displayed considerable initiative [ ]

Displayed some initiative [ ]

Displayed little initiative [ ]

Displayed no initiative [ ]

4. Has the contract been partially or complete terminated for default?

[ ] YES

[ ] NO

If YES, briefly explain (i.e. inability to meet performance or delivery schedules).

5. Provide an overall rating of the contractor’s quality of the products supplied.

Excellent – conformed to contract/specification requirements [ ]

Satisfactory – slight nonconformances did not effect product [ ]

Unsatisfactory – nonconformance’s inhibited product usefulness [ ]

Poor – extensive non conformances [ ]

If the contractor experienced extensive non conformances, please explain below the circumstances surrounding nonconformance’s (i.e. inability to meet specification requirements).

6. Would you contract with the contractor again and would you refer this contractor to other potential sources?

[ ] YES

[ ] NO

If NO, please explain:___________________________________________________