ATTACHMENT_Past_Performance_Questionnaire.docx

ATTACHMENT - 7

PAST PERFORMANCE QUESTIONNAIRE

S O U R C E S E L E C T I O N S E N S I T I V E I N F O R M A T I O N

Note: Completed Questionnaire shall be considered confidential information and may not be seen or reviewed by the Contractor/Offeror. This form shall be sent by prospective offeror’s to three (3) references and shall be filled out completely by the reviewer. The Reviewer shall send directly to the contracting officer listed below.

Contract Number: Name of Offeror:

Contract Information

Name of Contractor: Contract Number: Contract Title: Contract Value:

Type of Contract: Period of Performance:

EVALUATOR IDENTIFICATION

A. Contracting Officer/Evaluator’s name and title:

B. Agency Name:

C. Agency Address:

D. Evaluator’s phone/fax number:

E. Evaluator’s email address:

F. Project Manager’s Name:

G. Project Manager’s phone/fax number:

H. Project Manager’s email address:

The ratings below are supplied by the contractor identified above, NOT the offeror.

This form will be completed by the offeror’s listed references. Ratings to be used are: Outstanding = 5; Exceeds Expectations = 4; Satisfactory = 3; Somewhat Unsatisfactory = 2; Very Unsatisfactory = 1, and Did Not Address = 0. Ratings should be supported with the appropriate comments. Additional pages may be used, as necessary.

1. Quality of Product or Service (e.g., technical knowledge, quality of deliverables) Rating

Comments.

2. Timeliness of Performance Rating:

(e.g., met milestones, deliverables on time) Comments:

3. Effectiveness of Management including subcontractors: Rating:

Comments:

4. Response to Technical Direction: Rating:

5. Responsiveness to Performance Problems: Rating:

6. Compliance with Cost Estimates: Rating:

7. Customer Satisfaction: Rating:

8. Overall Performance: Rating:

NOTE: IT IS THE RESPONSIBILITY OF THE OFFEROR TO obtain completed PAST PERFORMANCE QUESTIONNAIREs from all customers on projects listed in their proposal. All COMPLETED PAST PERFORMANCE QUESTIONNAIREs SHALL BE SUBMITTED AS PART OF THE PROPOSAL.

Reference; RFP# GS-H-1417-P0013, GSA NCR – OAS Administrative Support Services

Email past performance questionnaire to Carolyn Turner at Carolyn.turner@gsa.gov.