ATT_2_PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS: Offeror to complete Sections I and II and transmit questionnaire to reference listed in Section II Reference to complete Sections III and IV. The completed questionnaire shall be included in the Volume I submission by the offeror.

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO:

CONTRACTOR ADDRESS:

CONTRACT TYPE:

[ ] FIRM-FIXED-PRICE

[ ] COST REIMBURSEMENT

[ ] OTHER____________________________

[ ] ACTIVE [ ] COMPLETED

[ ] ROUTINE [ ] COMPLEX

DATES OF PERFORMANCE: AWARD AMOUNT $___________________

TOTAL WITH MODS $___________________

% SELF-PERFORMED ___________________

NOTE: Similar projects shall be greater than $500,000 and the contractor must have self-performed at 25% of the work.

PROJECT DESCRIPTION:

II. AGENCY (REFERENCE) IDENTIFICATION

AGENCY/CLIENT (REFERENCE) NAME:

TITLE/PHONE:

III. PAST PERFORMANCE RATING

Rating Scale: E = Excellent. Considerably surpassed requirements/expectations.

G = Good. Surpassed requirements/expectations.

S = Satisfactory. Met requirements/expectations

M = Marginal. Met some requirements/expectations

U = Unsatisfactory. Did not meet requirements/expectations

1. QUALITY: (Circle applicable rating)

a. Conformance with contract requirements E G S M U

b. Quality of workmanship E G S M U

c. General oversight by contractor E G S M U

f. Avoidance of accidents/safety violations E G S M U

2. TIMELINESS:

a. Adherence to project delivery schedules E G S M U

d. Response to correction of identified problems E G S M U

e. Submission of timely/accurate/complete billings E G S M U

f. Ability to meet project schedule milestones E G S M U

g. Submission of materials/other submittals E G S M U

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E G S M U

c. Relationships with subcontractors E G S M U

d. Relationships with client E G S M U

e. End user was satisfied with services performed/items provided E G S M U

4. SUMMARY RATING:

Would you use this contractor for the services/items acquired under this effort again?

IV. COMMENTS

Provide any additional comments for items in Section III

Item No. Comment

POC SIGNATURE/DATE:

Please provide contact information where you may be reached during normal business hours: