Past_Performance_Questionnaire_Template.pdf

PAST PERFORMANCE INFORMATION QUESTIONNAIRE

Instructions:

References are asked to complete all items set forth in this Questionnaire and should return the completed and signed form electronically to the vendor being evaluated with sufficient time for the vendor to include the completed questionnaire in its proposal submission.

Background Information

Name of Contractor being evaluated:

Name of Respondent, Position, and Title

Signature + Date of Respondent

Agency/Employer name:

Respondent’s Contact information:

Telephone:

Fax:

e-mail:

Referenced Contract/Order Number for which information is being provided:

Period of performance for referenced contract/order:

Contract/order award date:

Contract/order amount (including options exercised):

Contract type:

Fixed-Price

Cost Plus Incentive Fee

Labor-Hour/T&M

Cost Plus Award Fee

Cost Plus Fixed Fee

Other (Please provide Contract Type)

Was the Contractor for which this reference is being provided the Prime Contractor?

Yes

No

Description of the contract/order work:

Names of key Contractor personnel (if applicable):

Evaluation

For each performance element identified below, references should evaluate performance of the firm or individual identified above in this form. Where the reference lacks sufficient information to provide an evaluation for a particular performance element, this should be noted. Where any deficiency or unfavorable information is identified, the reference should identify any mitigating factors that may weigh in favor of the person/firm on whose behalf the reference is provided (i.e., problems due to causes outside the contractor’s control). An individual within your organization who is knowledgeable of the Contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the Contractor’s performance with the judgment of others within their organization, as applicable.

Date this questionnaire was completed:

Evaluation of Past Performance

Definitions of Potential Ratings for Questions Below:

Adjective Description Excellent (E) Performance exceeds contract requirements or customer expectations for the element being assessed a significant amount of the time. There were no issues/problems or a few minor problems for which corrective action taken by the contractor was highly effective.

Good (G) Performance met and sometimes exceeded contract requirements or customer expectations. Issues/problems were minor for which corrective action taken by the contractor was effective.

Satisfactory (S) Performance only meets contract requirements or customer expectations. Issues/problems occurred for which corrective action taken by the contractor were satisfactory and may have required minor Agency resources for the contractor to achieve contract requirements.

Marginal (M) Performance did not meet some contract requirements or customer expectations. Issues/problems occurred for which corrective action taken by the contractor appear only marginally effective or were not fully implemented and may have required more than minor Agency resources for the contractor to achieve contract requirements.

Unsatisfactory (U) Performance does not meet most contractual requirements or customer expectations and recovery is not likely in a timely manner. There were serious issues/problems for which the contractor’s corrective actions appear or were ineffective.

Not Applicable (N/A)

Reference has no knowledge of Contractor’s past performance in this area, reference has insufficient information to provide a rating in this area, or question does not apply to the referenced contract.

1) QUALITY OF PRODUCT OR SERVICE

Contractor’s ability to meet minimum quality requirements specified in contract

E G S M U N/A

Please provide answers to the questions listed below. When responding to the questions listed, circle the letter that most accurately describes the contractor’s performance or situation (see the “ratings” chart below for a description of each letter). For any Marginal or Unsatisfactory rating, please provide explanatory narratives in the “Remarks” section at the bottom of this questionnaire. These remarks need not be lengthy, just detailed. If more space is required, attach additional pages. Handwritten responses to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.

Contractor’s ability to effectively control the quality of products or services provided

Contractor’s overall technical knowledge and expertise as applied to the contract requirements

2) DAY TO DAY MANAGEMENT

Contractor’s ability to effectively and efficiently manage and supervise its audit activities to ensure requirements were successfully performed

Contractor’s ability to provide flexible, proactive, and effective solutions in response to any issues or problems that appeared during contract performance

Contractor’s ability to effectively manage the contract/order from a contract administration standpoint

Contractor’s professionalism and business acumen

Contractor’s safeguarding of sensitive government data, including personal identifiable information

3) STAFF RECRUITMENT AND RETENTION

Contractor’s ability to provide and retain quality staff to within reasonable levels of turnover

Contractor’s changes to key personnel complied with the terms of the contract

4) TIMELINESS

Contractor’s ability to timely meet requirements for contract deliverables

Contractor’s ability to mitigate schedule risk when unanticipated events occur

Contractor’s ability to provide prompt notification of issues/problems and timely responses to inquiries, calls, or emails.

5) COST CONTROL

Contractor’s ability to manage its resources within cost limitations set forth in the contract

Contractor’s ability to submit current, accurate, complete, and timely invoices/billings

Contractor’s submission of change order proposals were reasonably necessary and fairly priced

Overall Remarks:

OVERALL RATING: