Attachment C - Past Performance Questionnaire.pdf

PAST AND PRESENT PERFORMANCE SURVEY

Janitorial Services at Jacksonville National Cemetery

Name of Respondent: ______________________________ Title: ______________________________ Address: ______________________________ Phone: ______________________________ Fax: ______________________________ E-Mail: ______________________________

General Information:

Contractor’s Name: _____________ ________________ Address: ______________________________ Telephone Number: ______________________________ Point of Contact: ______________________________

Project Title or Brief Description of work:

Contract Number: _____________________________ Contract Award Amount: $____________________________ Dates of Performance: _____________________________

Completed Survey Form Email To:

Charnell Cunningham charnell.cunningham@va.gov

Thanks for your assistance:

Charnell Cunningham Contract Specialist Department of Veterans National Cemetery Administration (NCA)

Performance Information: Choose the number on the scale from 1 to 6 that most accurately describes the contractor’s performance or situation. If the service/maintenance or any portion of the contract performance was subcontracted, please comment on the sub-contractor’s performance as well. Please provide a narrative explanation for any ratings of 1 or 6.

KEY:

Unsatisfactory (1) -Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.

Marginal (2) -Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.

Satisfactory (3) -Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

Very Good Performance (4) -Met all contractual requirements and exceeded some. There were a few minor problems which the contractor resolved in a timely effective manner.

Exceptional (5) -Exceptional performance of the contract requirements and exceeded many. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

1 2 3 4 5

Unsatisfactory Marginal Satisfactory Very Good Exceptional N/A

1. The contractor successfully provided the same or similar as Janitorial Services.

1 2 3

5 N/A

2. The contractor’s personnel are qualified and experienced to perform the contract requirements.

1 2 3 4

3. The contractor performed services according to Schedule/SOW/PWS.

4. The contractor demonstrated an overall effective management effort.

5. The contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) or Contract Specialist (CS) was apprised to technical, cost, and scheduled issues.

6. Contractor promptly notified the COR and/or CS in a timely manner regarding urgent issues.

7. Contractor had enough staff and backup staff to perform services without interruption.

8. How would you rate the contractor for their overall contract performance?

9. Would you award to this company again? 1 2 3 4

Narrative Description (As Necessary):