Past Performance Questionnaire.pdf

Section J Attachment 1

Past Performance Questionnaire

Referenced Contractor (contractor you are providing past performance information about):

Name:_________________________________________________________________

Type of Contract Work Performed by the referenced contractor:

Contract Value: ______________

Date of Award:____________ Date Completed:______________

If not complete provide status:_________________________________

Complexity of Work Performed: Difficult _______ Routine _______

Name of Company and Point of Contact Providing this Past Performance Information:

Company Name:_____________________________________________________________

Point of Contact:_____________________________________________________________

Telephone Number: __________________________________________________________

Performance Elements

How was the Contractor rated in the following areas:

Excellent Good Marginal None Poor

Quality of Work

Timely Performance

Effective Management

Contract Compliance

Rating Scale:

Excellent: Performance is superior and as a customer, would unhesitatingly do business with the offeror again.

There is little or no room for improvement. Offeror performs in accordance to specifications, etc. Complaints are negligible, or the record is old and the offeror has demonstrated by more recent performance that corrective action has made the likelihood of such conduct in the future highly improbable.

Good: Offeror's performance is better than average, and the customer, would willingly do business with the offeror again. Complaints are few and relatively minor. Complaints are negligible, or the record is old and the offeror has demonstrated by more recent performance that corrective action has made the likelihood of such conduct in the future highly improbable.

Marginal: Unfavorable reports regarding the offeror's performance have been made. Serious doubt is expressed as to whether or not as the customer business would be done again. However, some favorable reports are given, and some sources state they would do business with the offeror again. Much improvement is needed to bring performance level up to a manner that is acceptable.

NEITHER UNFAVORABLY NOR FAVORABLY - (None) No record exists or sources of information are roughly divided over the quality of the offerors performance. The offeror has no record of criminal conduct, civil fraud, negligence, or the record is old. In the case of an offeror with respect to which there is no information on past

Section J Attachment 1 contract performance or with respect to which information on past contract performance is not available, the offeror may not be evaluated favorably nor unfavorably on the factor of past performance. These vendors will be evaluated on specification and price only.

Poor: Performance is unsatisfactory and the customer would no longer do business with the offeror again.

Complaints are substantial or numerous. The offeror either has presented no persuasive evidence of having taken appropriate corrective action that will guard against such conduct in the foreseeable future, or it appears unlikely that the corrective action will be effective. Constantly corresponding with vendor to get the vendor to perform by issuing "Cure Notice(s)" and/or "Show Cause" Notice(s) consideration taken to re-establish delivery dates and any other adverse action such as "Termination for Default"

Performance History

1.) Did the Contractor adhere to the contract schedule?

COMMENT:

2.) Were any problems experienced in the Contractor’s performance? If so, to what extent was the Contractor able to resolve the problems without extensive help from your staff?

COMMENT:

3.) How well do you think the Contractor interfaced with your staff?

COMMENT:

4.) Based on past experience with this Contractor, would you consider using them again if there was a need?

5.) Based on the above information, what is your overall rating of the Contractor?

Excellent (__) Good(__) Marginal(__) None(__) Poor(__)

Printed and signature of person who completed this questionnaire:

Printed Name

Signature