Past and Present Performance Questionnaire.PDF

Revised Feb 21 2020

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

“Contractor Name = the contractor responding to the solicitation”

Telephone Number: _____________________Contractor’s Name: ____________________________ Address: ____________________________________

Fax Number: _________________________

Point of Contact: ______________________

Project Title and Brief Description of Work: _________________________________________

Contract Period of Performance Provided by Offeror:

Contract Number Reference: Dollar Amount:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts for the same or similar requirement with your agency/organization in the last three (3) years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

“Respondent = Name of the Reference filling out the Questionnaire”

Title: ___________________________Name of Respondent: ___________________

Address: _____________________________

Telephone Number: ___________________

Fax Number:_________________________

Email Address: _______________________

C. E-MAIL COMPLETED SURVEY FORM TO:

Date:

file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/Far02.doc%23T2101 file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/FAR03.DOC%23b3104

Revised FEB 21 2020

CONTRACTOR’S NAME: ________________________________________

CONTRACT NUMBER: __________________________________________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

D. PERFORMANCE INFORMATION: Choose the appropriate number on the scale (1, 2, 3, 4, and

5) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A

NARRATIVE EXPLANATION FOR ANY RATINGS OF 4 or 5.

1 2 3 4 5

Substantial

Confidence

Satisfactory

Confidence

Limited

Confidence

No Confidence Unknown

Confidence

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective

Performance was not observed or not applicable to the current effort being reported against

Place an “X” in the appropriate column using the definitions matrix above.

THE CONTRACTOR 1 2 3 4 5

1 Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2 Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3 Delegated authority to project managers and supervisors commensurate with contract requirements.

4 Home office participated in solving significant local problems.

5 Followed approved quality control plan.

6 Provided effective quality control and/or inspection procedures to meet contract requirements.

7 Corrected deficiencies in timely manner and pursuant to their quality control procedures.

file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/Far02.doc%23T2101 file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/FAR03.DOC%23b3104

Revised Feb 21 2020

THE CONTRACTOR 1 2 3 4 5

8 Provided timely resolution of contract discrepancies

9 Identified problems as they occurred.

10 Suggested alternative approaches to problems.

11 Displayed initiative to solve problems.

12 Developed realistic progress schedules.

13 Met established project schedules.

14 Provided timely resolution of warranty defects.

15 Was responsive to contract changes.

16 Provided adequate project supervision.

17 Obtained consent of surety for increases in bonding as work-in-progress increased.

18 Paid subcontractors/suppliers in a timely manner.

19 Provided accurate and complete line item cost proposals including all aspects of work required for each task.

20 Cooperated with Government personnel after award.

21 How would you rate the contractor's overall performance?

22 Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

23 Would you award another contract to this contractor? If not, explain in “remarks.”

YES/NO

24 Is the contractor rated in CPARS? YES/NO

Additional Remarks

If you require further information from the COR/technical POC you may contact ______________.

Email:

file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/Far02.doc%23T2101 file:///C:/Documents%20and%20Settings/Bernadette.Breeding/matthew.gross2/PAM/New%20for%20FY08-1%20Oct/far/FAR03.DOC%23b3104