SSP_Attachment_3_-_Past_Performance_Questionnaire.doc

Source Selection Information – See FAR 3.104

Storefront Glass Graphics Using Perforated Window Film

M00263-16-R-1004 - PAST PERFORMANCE QUESTIONNAIRE

We will treat the information contained in the completed survey as source selection sensitive information and will not disclose it to anyone other than those on the evaluation board with a need to know.

Part I – General Information

PART I.

A. SOLICITATION DATA

Solicitation Number: M00263-16-R-1004 Project/ Requirement: Storefront Glass Graphics Using Perforated Window Film Customer/Agency: Marine Corps Recruiting Command

B. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:_____________________________ Program Identification/Title:_________________________ Contract Number:________________________________ Contract Award Date:_________________________________________

C. ASSESSOR INFORMATION

Name:______________________________ Title:_______________________________ Telephone Number:__________________ E-mail Address:_____________________ Rating Scale:

The following definitions should be used in your assessment of Contractor’s performance.

Excellent: Performance Exceeds Most contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns. The Risk Level - NONE.

Good: Performance Exceeds SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective. The Risk Level is - LOW Satisfactory: Performance MEETS contractual requirements. The performance of areas being assessed contains minor issues or concerns, for which the Contractor’s corrective actions were highly effective. The Risk Level - LOW Marginal: Performance MEETS SOME contractual requirements. The performance of areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective. The Risk Level - Moderate Un-Satisfactory: Performance DOES NOT MEET contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which the Contractor’s corrective actions were ineffective. The Risk Level - High Past Performance Evaluation Questions

QUALITY OF PERFOMANCE:

1. To what extent was the contractor in compliance with the contract requirements?

· Excellent

· Good

· Adequate

· Marginal

· Poor

· Too soon to tell

· Not Applicable

Narrative_________________________________________________________________________________________________________________________________________________________________________________________

2. To what extent was the contractor’s ability to adhere to schedules and complete work on time?

· Excellent

· Good

· Adequate

· Marginal

· Poor

· Too soon to tell

· Not Applicable

Narrative____________________________________________________________________________________________________________________________________________________________________________________

MANAGEMENT PERFORMANCE:

3. To what extent were the contractor’s responsiveness to business relations, teamwork, and customer satisfaction?

· Excellent

· Good

· Adequate

· Marginal

· Poor

Narrative____________________________________________________________________________________________________________________________________________________________________________________

PRICE:

4. To what extent did the contractor stay within price estimates for developmental activities?

· Excellent

· Good

· Adequate

· Marginal

· Poor

Narrative____________________________________________________________________________________________________________________________________________________________________________________ NAME (Printed)/Phone ____________________________________________

SIGNATURE DATE_______________________________________________

Comments: (attach additional sheets if necessary) ______________________________________________________________

OVERALL RATING OF CONTRACTOR’S PERFORMANCE:

· Excellent: Good: Satisfactory:

Marginal:

Un-Satisfactory:

Narrative__________________________________________________________________________________________________________________________________________________________________________________________

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Source Selection Information – See FAR 3.104