Attachment_G_Past_Performance_Survey_Form.docx

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Crew Protection Kit (CPK) for the Light Capability Rough Terrain Forklift (LCRTF).
Solicitation number
M67854-13-R-5024
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Attachment G Past Performance Survey Form

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ATTACHMENT G:

PAST PERFORMANCE SURVEY FORM

Your assistance is requested by the Marine Corps Systems Command/CTQ to assist with establishing the performance history for the contractor named below. Please complete this questionnaire and email it to the following:

Marine Corps Systems Command/Code CTQ Attn: Mr. Mark Green 2200 Lester St.

Quantico, VA 22134-5010 mark.c.green@usmc.mil cc to: Kimberly.m.barnes@usmc.mil

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

Contractor Name & Address:
Contract No.:

Contract Award Date:

Completion Date:

Contract Value:

Type of Contract:

Evaluator Name/Title/Phone:

Description of Contract Requirements:

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

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