W56KJD-13-R-0020_PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PERFORMANCE QUESTIONNAIRE

For your convenience, a cover sheet for use in mailing is provided below.

General Support Contracting Center Attn: Trevor Skelly, LT, SC, USN

Camp Phoenix

Kabul, Afghanistan

From: (Name and Address of Organization) __________________________________________________

(Point of Contact Name) __________________________________________________

(Facsimile/Phone Number) __________________________________________________

(E-mail Address) __________________________________________________

To (Point of Contact Name) Trevor Skelly, LT, SC, USN

(E-mail Address) trevor.j.skelly@afghan.swa.army.mil

CONTRACTOR PERFORMANCE QUESTIONNAIRE

CONTRACTOR NAME: CONTRACT NUMBER:

EVALUATION PERIOD: DELIVERY ORDER NO.:

1. Please describe the service/supply provided by the Contractor for your organization.

2. Please provide ratings and comments regarding the Contractor’s performance in each area below using the following ratings: Exceptional, Very Good, Satisfactory, Marginal, or Unsatisfactory. See next page for definition of ratings. For ratings of “Exceptional” or “Unsatisfactory,” please provide a brief explanation.

EXCEPTION

AL

VERY

GOOD

SATISFACTO

RY

MARGIN

AL

UNSATISFACT

ORY

OVERALL PERFORMANCE

RATING

Please provide an overall rating of the Contractor’s performance for the referenced contract/delivery order.

a.) Quality of Product or

Service: Conformance to contract requirements, appropriateness of personnel, accuracy of reports, and technical excellence b.) Timeliness or Scheduling of

Supplies/Deliveries: Timeliness of performance, met interim milestones, reliable, responsive to technical and contractual direction as to scheduling.

c.) Business Relations/Customer

Satisfaction: Effective management, prompt notification of problems, reasonable/cooperative behavior, proactive, timely award and management of subcontracts, effective small business/small disadvantaged business subcontracting program and satisfaction with Contractor’s service.

d.) Key Personnel and Staffing

(Including Subcontractors):

Qualified personnel, effective performance and conduct.

3. Would you hire this Contractor to provide supplies/services for your organization in the future? Yes No

Please provide comments using additional pages if desired.

Signed:__________________________________

DEFINITION OF RATINGS FOR PAST PERFORMANCE

Exceptional

Performance meets/met contractual requirements and exceeds/exceeded many to the customer’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good

Performance meets/met contractual requirements and exceeds/exceeded some to the Customer’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets/met contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

Marginal Performance does not/did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet or did not identify corrective actions.

Unsatisfactory

Performance does not/did not meet most contractual requirements and if currently being performed, recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor's corrective actions appear or were ineffective.