Area A Power Attachment G - Past Performance Evaluation Questionnaire.doc
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- HSHQDC-08-R-00070
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Attachment G - Past Performance Questionnaire
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Attachment G Past Performance Evaluation Questionnaire PART ONE: General Information
GENERAL INFORMATION
1. OFFEROR’S NAME AND ADDRESS
2. CUSTOMER ORGANIZATION
3. CONTRACT NUMBER:
2a. EVALUATOR
4. CONTRACT VALUE: _______________________
NAME:
TITLE:
PHONE NO:
5. CONTRACT AWARD DATE:
6. CONTRACT COMPLETION DATE:
7. LOCATION OF WORK: _______________________________
8. COMPLEXITY OF WORK (Circle One Response):
DIFFICULT
ROUTINE
9. CONTRACT TYPE (Circle All That Apply):
Fixed Price _____ Cost Reimbursement ____
Other: (Specify) __________________
PART ONE: General Information Continued
10. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:
PART TWO: Offeror Performance Rating On the following pages, please summarize the Offeror’s performance in each rating factors. Each factor has a set of subfactors with four possible adjectival ratings. Determine the adjectival rating that most nearly represents your experience with this Offeror and indicate your assessment by placing an “X” under the appropriate heading. Offeror performance factors are:
A. CORPORATE COMMITMENT
B. QUALITY OF SERVICES/PRODUCT
C. TIMELINESS OF PERFORMANCE
| EXCELLENT |
| Contractor’s performance significantly exceeded the contract requirements |
| GOOD |
| Contractor’s performance exceeded the contract requirements. |
| ACCEPTABLE |
| Contractor’s performance met contract requirements. |
| UNSATISFACTORY |
| Contractor’s performance was less than acceptable and was unable to perform contract requirements successfully. |
| N/A |
| Not Applicable. |
| A |
| CORPORATE COMMITMENT |
| Outstanding |
| Good |
| Accept. |
| Unsat. |
| N/A |
| 1 |
| Did the Contractor provide effective contract and project management? |
| 2 |
| How effective has the Contractor been in understanding and responding to user requirements? |
| 3 |
| Did the Contractor establish and maintain effective quality control standards and procedures? |
| B |
| QUALITY OF SERVICE |
| Outstanding |
| Good |
| Accept. |
| Unsat. |
| N/A |
| 1 |
| Did the Contractor provide quality goods/services? |
| 2 |
| Did the Contractor provide quality reports and documentation (i.e., accurate, current and complete)? |
| 3 |
| Was the Contractor able to solve contract performance problems without extensive guidance from counterparts? |
| 4 |
| Did the Contractor supply professional and qualified personnel? |
| 5 |
| How well did the Contractor manage the following areas: |
(a) subcontractors and suppliers
(b)labor force
(c) Cost
| C |
| TIMELINESS OF PERFORMANCE |
| Outstanding |
| Good |
| Accept. |
| Unsat. |
| N/A |
| 1 |
| Did the Contractor adhere to contract schedules in the following areas: |
(a) Performance of services?
(b) Delivery of reports or other documentation?
PART TWO: Offeror Performance Rating Continued
1.
Has this contract been terminated for default?
YES
NO
If yes, please explain (e.g. inability to meet cost, performance, or delivery schedules - also include contract number, name, address, and phone number of Terminating Contracting Officer - TCO).
2.
What was the Contractor’s greatest strength in the performance of the contract?
3.
What was the Contractor’s greatest weakness in the performance of the contract?
4.
Would you award another contract to this Contractor?
YES
No
COMMENTS:
Other Remarks:
Please use the space below to provide other information related to the Contractor’s performance. This may include the Contractor’s selection and management of subcontractors, and the flexibility in dealing with contract challenges.
PART THREE: Evaluator's Certification
I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
SIGNATURE OF EVALUATOR
TITLE OF EVALUATOR
DATE
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