Attachment 6 - Past Performance questionaire.docx

Past Performance Questionnaire - Attachment 6

GLNPOCS Past Performance Questionnaire

Source Selection Sensitive Information – FAR 2.101 and FAR 3.104

Name of offeror: ____________________________________

Client/Contract Information (supplied by offeror)

Contract Information

Name of Contractor/Client:

Contract Number:

Type of Contract:

Period of Performance:

Project/Requirement Description/Location/Relevance to this requirement:

Evaluation Definitions

The following definitions should be used in your assessment of Contractor performance.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

VERY GOOD

Performance EXCEEDS SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.

NOT APPLICABLE (N/A)

Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Performance Evaluation

The ratings (as applicable) below are supplied by the contractor identified above, NOT the offeror.

Performance Elements

Unsatisfactory

Marginal

Satisfactory

Very Good

Exceptional

Not Applicable N/A

1. Timeliness of Performance

2. Business Relations

3. Customer Satisfaction

4. Quality of Service or product

5. Effectiveness of Management

6. Cost Control

7. Safety

8. Remarks on exceptional performance (Provide data supporting this observation; you may continue on a separate sheet if needed.):

9. Remarks on unsatisfactory performance (Provide data supporting this observation; you may continue on a separate sheet if needed.):

10. Please identify any corporate affiliations with the offeror.

11. Would you do business with the offeror again?

12. Questionnaire completed by:

Name

Title

Mailing Address (Street and P.O. Box)

City, State and Zip Code

Telephone Number/ Fax Number

Email Address