Attch 4 Past Performance Questionnaire.docx

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Sewage Laboratory Testing Services
Solicitation number
M00264-12-T-0113
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Attachment 4 Past Performance Questionnaire

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Attch 2 Quality Assurance Surveillance Plan_SEWAGE LAB ANALYSIS_CN.doc DOC document
Solicitation M00264-12-T-0113.doc DOC document
Attch 1 Test Listing Revised CN.xls XLS spreadsheet
Attch 3 Non-Disclosure Agreement.doc DOC document

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Attachment 4 Past Performance Questionnaire Your assistance is requested by the Regional Contract Office, NCR to assist with establishing the performance history for the contractor named below. Please complete this questionnaire and email, or FAX, it to the following:

Regional Contract Office, NCR Attn: Ms. Tammy Lopez 2010 Henderson Road Marine Corp Base Quantico, VA 22134-5001 Ph. 703-784-1923

FAX 703-784-5908

When Complete, the information on this form is Source Selection Sensitive (41 USC 423).

Contractor Name & Address:
Contract No.:

Contract Award Date:

Completion Date:

Contract Value:$

Type of Contract:

Evaluator Name/Title/Phone:

Description of Contract Requirements: Furniture, installation and reconfiguration of furniture

Evaluation:

A1. Quality of Product, Performance Capabilities, and Vendor Service |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

B1. Effectiveness of Business Organization and Management.

|_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

B2. Delivery Schedule Compliance for Services and Products |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

B3. Service, Warranty, and Overall Quality of Product Support |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

C1. Customer Satisfaction – Product Performance & Quality |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

C2. Customer Satisfaction - Business/Management Relations.

|_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

C3. Customer Satisfaction – Service and Warranty |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

D1. Overall Rating for Product Quality and Vendor Performance |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

General Comments:

The information provided has been previously shared with the Contractor - |_| YES |_| NO

Please address questions regarding the use of this form to Ms. Tammy Lopez @ 703-784-1923 Source Selection Sensitive – FAR 3.102

Source Selection Sensitive – FAR 3.102

File details come from the government source that posted it. Updated .