Past Performance Survey .doc
DOC document 43 KB Posted
- Solicitation number
- 1131PL26R0058
About this file
This is a Past Performance Survey template issued by the United States Trade and Development Agency (USTDA) for the solicitation titled "Regional MENA - Europe and Eurasia Digital Infrastructure Opportunities" (Solicitation Number: 1131PL26R0058). The survey is designed to be completed by references or past clients who have worked with contractors bidding on this small business set-aside procurement. Completed surveys must be submitted to USTDA's Office of Acquisition Management at Contractproposals@ustda.gov no later than 2:00 PM on September 11, 2026 (Arlington, VA time).
The survey requests evaluations across six primary dimensions of contractor performance: compliance with contract terms and conditions, schedule performance, ability to meet actual requirements, implementation of corrective measures, and overall recommendation for future business engagement. Respondents rate confidence levels on a five-point scale (Substantial, Satisfactory, Limited, Unknown/Neutral, or No Confidence) for the first four questions, provide yes/no responses with explanatory comments for the fifth question regarding future business recommendations, and may provide additional comments on overall contractor performance. The template also includes fields for basic information such as the contractor's name, contract number, contracting agency, period of performance, service description, and total contract value. This is a standard reference-checking instrument used to assess past performance as an evaluation factor in the procurement process.
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Solicitation Number: 1131PL26R0058 Solicitation Title: Regional MENA – Europe and Eurasia Digital Infrastructure Opportunities PSS
PAST PERFORMANCE SURVEY
Please Submit Completed Survey to USTDA’s Office of Acquisition Management at Contractproposals@ustda.gov, no later than 2:00 PM, September 11, 2026, Arlington, VA Time.
Name of Contractor Being Reviewed:
Contract Number/Reference Information:
Name of Agency/Organization Submitting Review for this Contractor:
| Name of Person Completing Questionnaire |
| Phone Number |
| Email Address |
| Period of Performance: XX/XX/XXXX – XX/XX/XXXX |
| Brief Description of Services: XXXXXXXXX |
Total Contract Value: $XXXX.XX
Contract Performance Information
| Questions: |
| Response: |
| 1. How would you rate your confidence in the contractor’s ability to comply with contract terms and conditions? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 2. How would you rate your confidence in the contractor’s ability to complete work on schedule? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 3. How would you rate your confidence in the contractor’s ability to comply with the actual requirements? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
| 4. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence? |
| · Substantial Confidence |
· Satisfactory Confidence
· Limited Confidence
· Unknown/Neutral Confidence
· No Confidence
5. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.
· Yes
· No
Comment:
| 6. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss? |
| · Yes |
· No Comment:
USTDA sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.
Additional Comments:
PAGE
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