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FEDERAL AVIATION ADMINISTRATION

PAST PERFORMANCE QUESTIONNAIRE

You have been identified by as a reference.

Kindly provide the following information:

1. Contract Type and Description of Requirements

2. Contract Value at Award and at Completion or Currently

3. Was Project on Schedule, if not, who was responsible

Yes No

Owner Contractor Both

4. For the following check the number that is most applicable:

1. Excellent 2. Good 3. Satisfactory 4. Poor

QUALITY OF SERVICE – CUSTOMER SATISFACTION

a. Responsiveness 2.

3.

4.

b. Compliance 2.

c. Cooperation

2.

d. Quality of Work

2.

e. Technical Expertise

2.

f. Customer Satisfaction

2.

5. Would you recommend award to this contractor?

Yes Yes with reservations No If yes with reservations or no, please summarize

6. Rater’s Name – Title - Address – Telephone No.

7. Signature Date

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