Past Performance Evaluation Questionnaire - Attachment 1.pdf
PDF 177 KB Posted
- Attached to
- Outreach Support Services
- Solicitation number
- W911NF26RA002
About this file
This is a Past Performance Evaluation Questionnaire Form (W911NF-26-R-A002 - Attachment 1) used by the U.S. Army Corps of Engineers to assess contractor performance on federal contracts. The form is designed to gather information about a contractor's past performance within the preceding three years and current performance to inform federal contract award decisions. Respondents must provide factual and accurate information with supporting examples and explanations using five adjectival rating categories: Outstanding, Good, Acceptable, Marginal, and Unacceptable. Outstanding ratings require contractors to exceed many contractual requirements with minimal problems and highly effective corrective actions. Good ratings indicate performance that meets requirements while exceeding some, with effective corrective actions for minor problems. Acceptable ratings reflect compliance with contractual requirements with satisfactory corrective actions for minor issues. Marginal ratings indicate failure to meet some requirements with serious problems and ineffective or unidentified corrective actions. Unacceptable ratings signify failure to meet most requirements with serious problems and ineffective corrective actions.
The form contains three parts for completion. Part I requires the offeror to provide contract identification information including contractor name and division, address, program title, contract number and type, prime contractor name if applicable, award date, completion date, and a description of contractual effort or items purchased. Part II requires evaluation by the point of contact or respondent, rating the contractor across six performance areas: compliance of products, services, and deliverables to specifications and standards of good workmanship; effectiveness of project management including subcontractor use and control; timeliness of performance for services and product deliverables; effectiveness in forecasting and controlling estimated costs; commitment to customer satisfaction and business-like concern for customers' interests; and general comments on other relevant performance information. Outstanding, Marginal, and Unsatisfactory ratings require accompanying explanations in comments fields. Part III provides submission instructions requiring return via email as directed in the solicitation, along with respondent identification information including organization, name, title, date, telephone number, address, and email address.
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Text version
W911NF-26-R-A002 - ATTACHMENT 1
PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM
Contractor Contract No.:
Subcontract No. (if applicable):
POC: Title:
(Name)
(Agency, Telephone No., E-mail Address & Fax Number)
The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.
Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.
Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.
Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.
PART I. (To be completed by the Offeror)
Contractor Name/Division:
Contractor Address:
Program Title:
Contract Number:
Contract Type:
Prime Contractor Name (if different from the contractor name cited above):
Contract Award Date:
Forecasted or Actual Contract Completion Date: Description of the Contractual Effort or Items purchased:
Name:
Title:
Date:
Telephone Number:
Address:
E-mail Address:
Part II. Evaluation (To be completed by Point of Contact – Respondent)
Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)
Comments:
Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)
A. Contract Identification
B. Identification of Offeror’s Representative
A. Compliance of Products, Services, Documents and Related Deliverables to Specification Requirements and Standards of Good Workmanship
B. Effectiveness of Project Management (to include use and control of subcontractors).
Comments:
Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)
Comments:
Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)
Comments:
Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)
Comments:
C. Timeliness of Performance for Services and Product Deliverables.
D. Effectiveness in Forecasting and Controlling Estimated Costs
E. Commitment to Customer Satisfaction and Business-like Concern for its customers’ interest.
F. General Comments. Provide any other relevant performance information.
Organization:
Name:
Title:
Date:
Telephone Number Address:
E-mail Address:
PART III. RETURN INFORMATION
Please return this completed Questionnaire via e-mail as instructed in the solicitation.
Date Signature
William A Creech Typed or Printed Name
G. Other Information Sources. Please provide the following information:
Are you aware of other relevant past efforts by this company?
If yes, please provide the name and telephone number of a point of contact:
H. Respondent Identification. Please provide the following information:
Thank you for your assistance.
| W911NF-20-R-0002 - ATTACHMENT 1 |
| PART I. (To be completed by the Offeror) |
| Outstanding (Explanation must be provided in Comments field below) |
| Marginal (Explanation must be provided in Comments field below) |
| Outstanding (Explanation must be provided in Comments field below) |
| Marginal (Explanation must be provided in Comments field below) |
| Outstanding (Explanation must be provided in Comments field below) |
| Marginal (Explanation must be provided in Comments field below) |
| Outstanding (Explanation must be provided in Comments field below) |
| Marginal (Explanation must be provided in Comments field below) |
| Outstanding (Explanation must be provided in Comments field below) |
| Marginal (Explanation must be provided in Comments field below) |
| PART III. RETURN INFORMATION |
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