PrsntPast_Quest_Attachment_G.doc

ATTACHMENT G

PRESENT AND PAST PERFORMANCE QUESTIONNAIRE

Complete this form for each program being described. Provide frank, concise comments regarding your performance on the contracts you identify. If more space is required, continue on the back of form.

A. OFFEROR NAME (Company/Division):

B. PROGRAM INFORMATION:

1. PROGRAM TITLE:

2. CONTRACT NUMBER:

3. PROCURING AGENCY (Address/Phone):

4. GOVERNMENT PROGRAM MANAGER (Name/Address/Phone):

5. PCO [PROCURING CONTRACTING OFFICER] (Name/Address/Phone):

6. ACO [ADMINISTRATIVE CONTRACTING OFFICER] (Name/Address/Phone):

C. BRIEF DESCRIPTION OF EFFORT:

D. RELEVANCE OF EXPERIENCE TO THIS PROGRAM:

E. TYPE OF CONTRACT:

F. PERIOD OF PERFORMANCE:

*G. ORIGINAL CONTRACT $ VALUE:

1. CURRENT VALUE

2. VALUE AT COMPLETION (If different from current value, please explain):

*H. ORIGINAL COMPLETION DATE:

1. CURRENT SCHEDULE:

2. ESTIMATE AT COMPLETION:

3. HOW MANY TIMES CHANGED:

4. EXPLANATION FOR DELAYS:

I. DID THE CONTRACTOR MEET OR EXCEED ALL INITIAL PROGRAM MANAGEMENT AND TECHNICAL REQUIREMENTS? DID THE CONTRACTOR MEET OR EXCEED ANY RISK MANAGEMENT ISSUES AND COST CONTROLS? DID THE CONTRACTOR MEET OR EXCEED ANY QUALITY CONTROL PLANS OR QUALITY ASSURANCE SURVEILLANCE PLANS?

1. IDENTIFY WHICH REQUIREMENTS (IF ANY) WERE NOT MET:

2. WERE THOSE REQUIREMENTS WHICH WERE MET THE SAME AS

ORIGINALLY REQUIRED OR AS CHANGED?

3. MAJOR PROBLEMS ENCOUNTERED AND ANY CORRECTIVE ACTIONS TO PREVENT RECURRENCE OF PERFORMANCE THAT WAS SUBSTANDARD:

I. PRIME CONTRACTOR PROGRAM MANAGER (Name/Address/Phone):

J. SUBCONTRACTOR PROGRAM MANAGER (Name/Address/Phone):

K. USE THIS SPACE TO ADDRESS ANY TECHNICAL OR OTHER AREA OF CONCERN CONSIDERED UNIQUE:

*If not the prime contractor, give the actual description/period of performance and contract value of the subcontract effort you were responsible for under this contract