SB134117RQ0789 Attachment VI PastPerformanceQuestionnaire.pdf

SB134117RQ0789

ATTACHMENT VI

Past Performance Questionnaire

DATE:

NAME OF CONTRACTOR:

(Name of contractor you are filling this form out)

REFERENCE COMPANY:

POINT OF CONTACT:

(include title/position)

PHONE NUMBER

CONTRACT/JOB NUMBER:

TERM OF CONTRACT/JOB:

CONTRACT VALUE:

1. BRIEFLY DESCRIBE WHAT CONTRACTOR DOES/DID ON THIS PROJECT FOR YOU.

2. IS/WAS CONTRACTOR TIMELY IN FULFILLING CONTRACTUAL REQUIREMENTS?

3. IS/WAS CONTRACTOR RESPONSIVE TO CONTRACT REQUIREMENTS (Performance in accordance with contract terms/conditions)?

4. HAVE DEDUCTIONS BEEN TAKEN FOR FAILURE TO PERFORM REQUIRED TASKS OR

CONTRACT REQUIREMENTS?

*** Upon completion, the questionnaire is to be signed and dated, and emailed directly to:

michelle.dacanay@nist.gov by 2:00 PM EST, August 11, 2017. ***

5. HOW WELL DID THE CONTRACTOR PRODUCE REQUIRED REPORTS/DOCUMENTS?

6. WAS CONTRACTOR TERMINATED FOR CONTRACT DEFAULT? YES ( ) NO ( )

IF YES, PLEASE PROVIDE AN EXPLANATION.

7. WERE THERE ANY NOTABLE PROBLEMS WITH CONTRACTOR OR CONTRACT

PERFORMANCE?

8. WOULD YOU CONTRACT AGAIN WITH THIS CONTRACTOR FOR SAME/SIMILAR

SERVICE?

9. HOW WOULD YOU RATE THE PERFORMANCE OF THIS CONTRACTOR?

VERY GOOD ( ) GOOD ( ) FAIR ( ) POOR ( )

Signature Date

*** Upon completion, the questionnaire is to be signed and dated, and emailed directly to:

michelle.dacanay@nist.gov by 2:00 PM EST, August 11, 2017. ***