Attach_5_Past_Performance_Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

Company Name:

1. Reference Point of Contact Information:

Name:

City/State:

Telephone #:

Email:

2. Contract/Project Information:

Contract/Project Name:

Date of Contract:

Approx. Value of Services:

3. Services Received:

Briefly Describe Services Received:

4. Rate Services Received Please rate services received by entering and “X” in the applicable rating block below. Definitions for ratings are listed at the bottom of this form:

Quality of product or service—compliance with contract requirements, accuracy of reports, appropriateness of personnel, technical expertise.

Timeliness-compliance with contract timeliness requirements for providing the services.

Customer Service—courteous interactions, satisfaction of end users with contractor’s service, initiative and proactive suggestions, approaches and improvements

Overall satisfaction of performance/service, if applicable

5. Please Provide Written Comments To Explain Your Ratings (Use Additional Sheets If Necessary):

6. Rater:

Signature Printed Name & Title Date

Return completed form to:

NAVSUP FLC San Diego Contracts Code 250

Nancy Landeros 805-982-2189 nancy.landero@navy.mil

DEFINITIONS