N4523A18R1064_Attachment_J-4_Contract_Performance_Data_Sheet.docx

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N4523A18R1064 UF-34 and UF-137
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N4523A18R1064
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N4523A18R1064 Attachment J-4 Contract Performance Data Sheet

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CONTRACT PERFORMANCE DATA SHEET

N4523A18R1064 Attachment J-4

CONTRACTOR NAME____________________________________________________

Contract Number (Government Contracts):

Date Completed:

Contract Type:
FFP____ Cost Reimbursement ____ Other (Specify) ___________

Item/Service Description:

Contract Quantity/Period of Performance:

Customer Name:

Customer POC (Person who can verify data;

Name/Title/Phone #/Email):

Address:

Telephone:

Email:

PERFORMANCE INFORMATION

YES
NO
1
Were all supplies/services delivered within the original contract schedule?
2
Did all delivered supplies/services comply with the contract specifications/ statement of work?
3
Did any of the delivered supplies/services require replacement, modification or rework in order to be acceptable?
4
Were any modifications issued relaxing the contract specifications/delivery requirements?
5
Was any part of this contract terminated for default or cause?
6
Did you receive any quality awards?
7
If applicable, describe any corrective action(s) initiated to solve any problems/deficiencies on this contract. Discuss the success of the corrective action(s) taken.

NARRATIVE:

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