Performance Assessment Questionnaire.docx

Performance Assessment Performance Assessment Questionnaire – COVER LETTER

DEPARTMENT OF THE ARMY COMMAND/ACTIVITY LETTERHEAD

(DATE)

Insert Contracting Office

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) (Insert solicitation number)

Dear Sir/Ma'am;

The U.S. Combat Capabilities Development Command, Chemical Biological Center (CCDC CBC) is currently conducting a competitive source selection to evaluate Offerors on subject RFP. As part of this evaluation, we have requested that the Offerors provide information about their past performance on same or similar federal, state or local Government or commercial contracts as compared to North American Industry Classification System (NAICS) ######. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation.

Please complete the enclosure and return to the U.S. Army Contracting Command, Edgewood Contracting Division (ACC ECD), 8456 Brigade Street, Aberdeen Proving Ground MD 21010-5401, no later than 15 days after receipt of request or MONTH DAY, YEAR, whichever occurs first. Your questionnaire may be submitted electronically to Contract Specialist, Sheila Ramos at Sheila.l.ramos2.civ@mail.mil or Nicholas Granata Jr at Nicholas.granata.civ@mail.mil .

Your cooperation is greatly appreciated. Questions may be directed to POC or the undersigned at (insert telephone number).

Sincerely, NICHOLAS GRANATA JR

Contracting Officer

PERFORMANCE ASSESSMENT QUESTIONAIRE

Contractor: Contract No.: Subcontract No. (If applicable):

POC: Title: (Name) (E.G. PCO/ACO/TM)

(Agency, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor's record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division: Address:

Program Identification/Title: Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above): Contract Award Date:

Forecasted or Actual Contract Completion Date: Nature of the Contractual Effort or Items Purchased:

B. IDENTIFICATION OF OFFEROR'S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact - Respondent) A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Acceptable

· Unacceptable (Explanation must be provided in Comments field below)

Comments:

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables.

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers' Interest

F. General Comments. Provide any other relevant performance information.

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

Signature Date

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