PAST PERFORMANCE QUESTIONNAIRE.doc

PAST PERFORMANCE QUESTIONNAIRE

IDENTIFICATION INFORMATION:

SOLICITATION NO.:

OFFEROR:

AGENCY IDENTIFICATION:

NAME/ADDRESS:

POINT OF CONTACT:

TELEPHONE NUMBER:

CONTRACT NO:

CONTRACT TYPE:

CONTRACT AMOUNT:

PRODUCT/SERVICE

DESCRIPTION:

PERFORMANCE HISTORY:

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

Considerably surpassed delivery schedule

Met or exceeded delivery schedule (no unexcused delays)

Minimal delays (did not impact achievement of contract requirements)

Extensive unexcused delays

COMMENTS:

2. To what extent did the contractor submit required reports, technical manuals, drawings, and documentation in a timely manner?

Considerably passed minimum requirements

Met or exceeded contract requirements ( no quality problems)

Nonconformance (did not impact achievement of contract requirements

Excessive or extensive nonconformances

3. To what extent were the contractor’s reports and documentation accurate and complete?

Considerably passed minimum requirements

Met or exceeded minimum requirements

Nonconformances (did not impact achievement of contract requirements)

Excessive or extensive nonconformances

4. To what extent did the contractor display initiative in meeting requirements and controlling contract costs ?

Displayed considerable initiative

Displayed some initiative

Displayed little initiative

Displayed no initiative

5. Has the contract been partially or completely termination for default or convenience?

Default [ ] Convenience [ ]

[ ] Yes

[ ] No

If yes, explain ( e.g., inability to meet performance or delivery schedules).

6. Are there any pending terminations?

[ ] Yes [ ] No

If yes, explain and indicate the status.

7. Would you contract with this company again?

[ ] Yes [ ] No

If no, please explain