N4571A-26-R-0010_Attachment 2_ Past Performance Questionnaire.pdf
PDF 157 KB Posted
- Solicitation number
- N4571A-26-R-0010
About this file
This is a Contract Performance Customer Questionnaire template issued by the Naval Facilities Engineering Command (CNIC) Millington, designed to collect past performance evaluations from federal agencies and companies that have previously contracted with prospective offerors. The questionnaire is intended to serve as source selection sensitive information and is directed to the Contract Specialist rather than released to competing offerors.
The form requires reference providers to complete identification information for both the contractor being evaluated and the agency/company providing the reference, including points of contact, phone numbers, email addresses, and details about the contract period of performance and services rendered. Evaluators must assign ratings in three core areas—Quality of Service, Timeliness of Delivery, and Overall Customer Satisfaction—using a five-point scale of Unsatisfactory, Poor, Fair, Good, or Excellent, with detailed guidance for each rating level. Quality of Service encompasses compliance with contract requirements, technical excellence, budget adherence, and cost negotiation relationships. Timeliness of Delivery assesses achievement of interim milestones, reliability, and schedule compliance. Overall Customer Satisfaction evaluates effective management, businesslike correspondence, responsiveness, problem notification, cooperation, flexibility, and proactive engagement. The questionnaire also requests contract information including solicitation/contract number, contract type (Firm Fixed Price, Cost Reimbursement, or Other), period of performance, overall contract value, contract title, service description, and work complexity designation. Completed questionnaires should be submitted to Stephanie Blakey at CNIC Millington via email to stephanie.a.blakey.naf@us.navy.mil.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| N4571A-26-R-0010 0001 Questions.pdf | ||
| N4571A-26-R-0010 Resiliency Training (CYP).pdf | ||
| N4571A-26-R-0010_Exhibit A_Resource Material Menu.pdf | ||
| N4571A-26-R-0010_Attachment 1_Program Locations.xlsx | XLSX spreadsheet |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Contract Performance Customer Questionnaire
1. Please complete this questionnaire. Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information and will be sent directly to the Contract Specialist. This information is not to be released to the offeror. Completed questionnaires may be emailed to:
CNIC Millington, ATTN: POC, Stephanie Blakey
5720 Integrity Drive, Bldg. 457
Millington, TN 38055
Phone: (901) 305-9934 | Email: stephanie.a.blakey.naf@us.navy.mil
2. Please complete:
Company/Contractor Requesting Reference Agency/Company Name Providing Reference Company/Contractor Name Agency/Company Name
Point of Contact Name Point of Contact Name
Phone # POC E-mail / Phone #
E-mail address Period of Performance
Fax Number Supply/Service Provided
PAST PERFORMANCE RATING GUIDELINES
Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Poor, Fair, Good, or
Excellent. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for
“Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”
N/A - NOT APPLICABLE - Unable to provide a score. Performance in this area not applicable to effort assessed.
Ratings Quality of Service
-Compliance w/contract requirements
-Technical excellence
-Within budget
-Relationship of negotiated costs to actual
Timeliness of
Delivery
-Met interim milestones
-Reliable
-Delivery Schedule achieved
Overall Customer Satisfaction
-Effective Mgmt
-Businesslike correspondence
-Responsive to contract reqmnts
-Prompt notification of problems
-Reasonable/cooperative
-Flexible
-Pro-active
Unsatisfactory Nonconformances are comprising the achievement of contract reqmnts
Delays are compromising achievement of contract reqmts
Response is not effective
Poor Nonconformances require major agency resources to ensure achievement of contract reqmnts
Delays require major agency resources to ensure achievement of contract reqmnts
Response is marginally effective
Fair Nonconformances require minor agency resources to ensure achievement of contract reqmnts
Delays require minor agency resources to ensure achievement of contract reqmnts
Response is somewhat effective
Good Nonconformances do not impact achievement of contract reqmnts
Delays do not impact achievement of contract reqmnts
Response is usually effective
Excellent There are no quality problems There are no delays Response is effective
NOTE: Please use adjectival ratings from attached sheet.
12. Evaluation Factor 13. Rating 13. Comments (Attach additional sheets, if necessary.)
a. Quality of Service
b. Timeliness of Delivery
c. Overall Customer Satisfaction
15. Would you select this company/contractor again? Please explain. (Attach additional sheet if necessary.)
16. Name & Date:
17. Title:
PAST PERFORMANCE QUESTIONNAIRE
1. Company/Contractor Being Referenced: 2. Solicitation/Contract Number:
3. Address: 4. Contract Type:
Firm Fixed Price
Cost Reimbursement
Other (Please Specify)
5. Agency/Company Completing Reference: 6. Agency/Company POC, Phone & Fax:
7. Period of Performance:
8. Overall Contract Value: $
9. Title of Contract:
10. Description of Contract Service:
11. Complexity of Work: Difficult: Routine:
File details come from the government source that posted it. Updated .