Past_Performance_Quesionnaire_2_pages_4_26_24_.pdf

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this questionnaire and email to: (insert email) Desired Response Date: (insert response date)

When complete, the information in this form is SOURCE SELECTION INFORMATION (FAR 2.101 & 3.104 and shall be protected accordingly.

Notice to Contractor

Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise.

This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services.

The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.

TO BE COMPLETED BY OFFEROR

1. CONTRACTOR NAME & ADDRESS:

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

Pease add a continuation page if additional space is necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR’S NAME, POSITION (Project Manager/COR/Other) AND ORGANIZATION:

b. EVALUATOR’S PHONE NO: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A-G) that best reflects your experience with this contractor.

2. CONTRACT NO:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options):

6. TYPE OF CONTRACT (Fixed Price, FPI, etc.):

1a: NAME OF PRIME CONTRACTOR (if this questionnaire is for a team member on the SRI Ranch House project):

EX = Exceptional S = Satisfactory US = Unsatisfactory VG = Very Good MG = Marginal N/O = Not Observed

A. Quality of Products and Services – Assess the contractor’s conformance to contract requirements, specification, and standards of good workmanship (e.g. technical, professional, environmental, or safety and health standards). EX VG S MG US N/O B. Performance – Assess the contractor’s performance as the General Contractor or A/E (as appropriate) for the project. EX VG S MG US N/O C. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract. EX VG S MG US N/O D. Schedule – Assess the timeliness of contractor against the schedule of activities.

EX VG S MG US N/O

E. Cost Control – Assess the contractor’s ability to manage the contract budge and control costs.

EX VG S MG US N/O

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and user “friendliness”. EX VG S MG US N/O G. Overall Assessment. EX VG S MG US N/O