J.1.3 (Past Performance Questionnaire).pdf
PDF 200 KB Posted
- Attached to
- Federal Motor Vehicle Safety Standard (FMVSS) No. 213a, Child Restraint Systems Side Impact Protection
- Solicitation number
- 693JJ923R000222
About this file
This document is a past performance questionnaire for a contractor responding to solicitation number 693JJ923R000222 from the Department of Transportation's National Highway Traffic Safety Administration. The solicitation seeks proposals to meet Federal Motor Vehicle Safety Standard 213a requirements for improved child restraint systems to provide side impact protection. The past performance questionnaire requests ratings and commentary on the contractor's previous performance in areas such as quality of service, timeliness, cost control, and customer satisfaction on a government contract. It also asks whether the contractor has received any cure notices or show cause letters, contract terminations or defaults, reasons for contract value changes, and whether the respondent would award the contractor another contract based on past performance.
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Text version
Title: (FMVSS) No. 213a, Child Restraint Systems
RFP: 693JJ923R000222
PAST PERFORMANCE QUESTIONNAIRE
Source Selection Sensitive (when completed)
OFFEROR:
1. REFERENCE INFORMATION FOR:
Contractor:
Contract Number:
Type of Contract: ( ) Fixed Price Type ( ) Cost-Reimbursement Type ( ) Other:
Period of Performance:
Contract Value: (initial) $ (current)$
2. CONTACT INFORMATION: Please provide the following information for the person(s) providing the reference (to assist us in tracking responses received and resolving any conflicts in the evaluation process if necessary)
Name of Contact:
Phone & Fax Numbers:
Organization/Office:
Position Title/Grade:
Period of involvement in contract:
Questionnaire Completion Date:
PAST PERFORMANCE QUESTIONAIRE
For the following questions, please circle/check the appropriate rating. Comment lines are provided for additional information if the #2 or #1 rating is given (however the comment lines may be used to provide any additional information deemed noteworthy).
High Low
1. QUALITY OF SERVICE: 5 4 3 2 1
This area deals with compliance of contract requirements, to include appropriateness of personnel and technical excellence.
High Low
2. TIMELINESS OF PERFORMANCE: 5 4 3 2 1
This area deals with the contractor’s ability to meet milestones and delivery schedules, to include responsiveness to technical direction, completion of efforts on time including wrap-up and contract administration.
High Low
3. PRICE/COST CONTROL: 5 4 3 2 1
This area deals with the contractor’s ability to control price/cost escalation during performance to include appropriate budgetary estimates, current/accurate/complete billings/invoices, relationship of negotiated costs to actual, claim submissions, cost efficiencies, and change order issues.
High Low
4. CUSTOMER SATISFACTION: 5 4 3 2 1
This area deals with the contractor’s commitment to satisfaction and cooperative/reasonable businesslike behavior with own staff and customers to include: effective management, responsiveness to clients or Government program personnel, operates with honesty and integrity, prompt notification of problems, flexible and proactive qualities, effective contractor-recommended solutions, and effective subcontracting and teaming arrangements.
Comments (attach additional pages as necessary):
GENERAL INFORMATION: Please provide answers to the following questions.
5. Has the contractor ever been given a cure notice, show cause notice, suspension of progress payments, or other letters directing the correction of a performance problem; or has this contract been partially or completely terminated, or is there any pending termination actions? ( ) No ( ) Yes
If yes: ( ) Default ( ) Convenience; and please explain:
6. Changes in contract dollar value throughout the life of the contract are/were attributable, for the most part, to:
( ) Government-issued change orders ( ) claims submitted by the contractor ( ) other Government actions ( ) other contractor actions (please explain below)
7. Based on this contractor’s overall performance, would you award this contractor another Government contract?
( ) Yes ( ) No If no, please explain:
8. If any of the above responses are based on adverse past performance, have you discussed it with the contractor and has the contractor had an opportunity to comment?
( ) Not Applicable ( ) Yes ( ) No If yes or no, please explain:
File details come from the government source that posted it. Updated .