J4 Past Performance Questionnaire.docx

J.4 PAST PERFORMANCE QUESTIONNAIRE

I. Contract Identification

1. Contractor Name _________________________________________

2. Contract Identification No. ______________________

3. Contract Type _____________________

4. Period of Performance ________________ to ________________

5. Initial Estimated Total Contract Cost _____________________

6. Current Estimated (or Actual, if completed) Total Contract Cost ____________________

7. Description of Services/Products Provided

II. Customer Agency (or Company) Identification

1. Organization Name _____________________________________________________

2. Organization Description _________________________________________________

3. Geographic Distribution of Services/Products Acquired _________________________

4. Number of Users Served ________________

5. Name and Title of Respondent ____________________________________________

III. Contractor Evaluation Rating Guidelines It is essential that the individual providing reference information for a contractor understand the rating scale and the criteria for assigning a particular rating to a contractor’s performance. In general, the evaluation questions ask how well a contractor performed on an aspect of the contract. The performance rating scale has a normal range from “Unsatisfactory” to “Exceptional”. The ratings and general guidelines for their use are described below.

a) Unacceptable - Due to substandard performance, non-conformance to requirements, or non-responsiveness, the contractor has been unable to achieve contract requirements despite the additional use of significant customer resources.

b) Acceptable- With only minor exceptions, the contractor has generally met all contract requirements, performed up to expectations, and been responsive to the customer.

A. Contract Performance

1. Did the contractor adhere to the contract delivery schedule(s)?

Comments: ____________________________________________________________

2. Did the contractor submit required reports and documentation in a timely manner?

Comments: ____________________________________________________________

3. Were the contractor’s reports and documentation accurate and complete?

Comments: ____________________________________________________________

4. Was the contractor able to solve contract performance problems without extensive guidance from your organization?

Comments: ____________________________________________________________

5. Did the contractor demonstrate initiative in meeting contract requirements?

Comments: ____________________________________________________________

6. Did the contractor commit adequate resources in a timely fashion to meet contract requirements and successfully solve problems?

Comments: ____________________________________________________________

7. Did the contractor submit change orders and/or required proposals in a timely manner?

Comments: ____________________________________________________________

8. Did the contractor respond positively and promptly to technical direction, contract change orders, etc.?

Comments: ____________________________________________________________

B. Termination History

1. Has the contractor been partially or completely terminated under this contract for default or for the convenience of your organization?

If yes, please explain reasons for termination (e.g., inability to meet performance requirements): ______________________________________________________________________

2. Are there any pending termination actions?

If yes, please explain reasons and describe the status of the action: ______________________________________________________________________

C. Technical Performance

1. Did the contractor consistently meet performance targets?

Please describe the specific performance criteria and how they were measured: ______________________________________________________________________

D. Management Performance

1. Has the contractor been effective in managing its subcontractors?

Comments: ____________________________________________________________

2. Has the contractor committed adequate financial resources to meet contractual requirements?

Comments: ____________________________________________________________

3. Apart from technical requirements, has the contractor fulfilled all contract terms and conditions?

Comments: ____________________________________________________________

4. Did the contractor (and its subcontractors) assign qualified personnel to key management functions (e.g., project manager) for executing the contract?

Comments: ____________________________________________________________

E. Price/Cost Management

1. Did the contractor meet its proposed cost estimates?

Comments: ____________________________________________________________

F. Customer Satisfaction

1. Was your organization satisfied with the contractor’s performance?

Comments: ____________________________________________________________

G. Additional Comments

Please provide below any additional information not covered in the specific questions in sections A through F that may assist the government in evaluating the contractor’s performance.

Information recorded by:

Please send Past Performance Questionnaire directly to:

Borek, Maureen P, BorekMP@state.gov