J.2_Past_performance_Template.docx

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Attached to
Community and Municipal Governance Initiative (CAMI) in the Kyrgyz Republic
Solicitation number
SOL-176-15-000006
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Past Performance Template

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ATTACHMENT J.2- PAST PERFORMANCE QUESTIONNAIRE

REQUEST FOR PROPOSALS No.: SOL-176-15-000006

Please fill out the following questionnaire as clearly and as objectively as possible. The information you provide will be used for source selection purposes. Please send the filled out questionnaire directly to the United States Agency for International Development (USAID) in Kyrgyzstan by email at ., not later than March 31, 2015.

SECTION A: (To be filled by the offeror)

Offeror's Name:

Was the Offeror the Prime or Subcontractor on the project:

Project Name:

Project Scope/Description:

Period of Performance: Dollar Value of Contract:

Name of Contact Person: _Phone:

Date Contacted: Employer:

Contact’s Role or Knowledge of the Project:

SECTION B: (To be filled by the contact person named in section A above)

1. Please comment on your satisfaction with the Quality of Work:

2. Please comment on the Timeliness of Contract Performance:

3. Please comment on the Quality of your Relations with the Contractor during contract performance:

4. Please comment on the Contractor’s Ability to Control Costs:

Please provide comments on Contractor’s Key Personnel:

Other Comments:

Signature of the Referee:

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