Attachment_D_-_PP_Reference_Check_Form.pdf

PAST PERFORMANCE REFERENCE CHECK FORM

Reference’s Name:

Reference’s Organization:

Reference’s Phone Number:

Reference’s E-mail Address:

Offeror Being Checked:

Contract Being Checked:

Dollar Value of Contract:

Period of Performance of Contract: to

Reference is requested to rate the offeror in each of the contract performance areas listed below using the following adjectival ratings.

EXCEPTIONAL – Performance meets contractual requirements and exceeds many to the

Government’s benefit. (Risk level: Very low)

VERY GOOD – Performance meets contractual requirements and exceeds some to the

Government’s benefit. (Risk level: Low)

SATISFACTORY – Performance meets contractual requirements. (Risk level: Moderate)

MARGINAL – Performance does not meet some contractual requirements. (Risk level: High)

UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. (Risk level: Very high)

a) Technical (quality of product or service)

b) Cost control (not applicable for firm-fixed-price contracts or fixed-price contracts with economic price adjustment)

c) Schedule/timeliness

d) Management or business relations

e) Small business subcontracting (if applicable)

f) Customer service

g) Other

Comments:

Signature of Reference Date revision date 05/04/2017 older versions are obsolete and should not be used