A07_ATTACHMENT_6_to_SOL_-_PAST_PERFORMANCE_QUESTIONNAIRE_FORM.docx

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Linking Investigations in Trauma and Emergency Services (LITES), Indefinite Delivery Indefinite Quantity (IDIQ) Contract
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W81XWH-16-R-0033
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ATTACHMENT 6 to Sol - Past Performance Reference Questionnaire Form

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ATTACHMENT 6

PAST PERFORMANCE REFERENCE QUESTIONNAIRE FORM

PART A: PAST PERFORMANCE REFERENCE QUESTIONNAIRE (to be completed by Respondent)

Name of Offeror or Subcontractor: _______________________________________________

Contract or Order Number: ______________________________________________________

1. Compliance of products, services, documents and related contract deliverables to specification requirements and standards of good workmanship.

__ Exceeds Contractual Requirements (Explanation must be provided in Comments field below) __ Meets Contractual Requirements __ Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

Comments:

2. Adherence to contract schedules, including timely submittal of documentation required throughout contract performance.

__ Exceeds Contractual Requirements (Explanation must be provided in Comments field below) __ Meets Contractual Requirements __ Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

3. Effectiveness in forecasting and controlling project cost.

__ Exceptional (Explanation must be provided in Comments field below) __ Satisfactory __ Unsatisfactory (Explanation must be provided in Comments field below)

4. Demonstrated ability to resolve technical problems quickly and effectively.

__ Satisfactory

5. Commitment to customer satisfaction and business-like concern for its customer’s interest.

__ Satisfactory

6. Establishes and maintains adequate management of subcontractors.

__ Satisfactory

7. Overall satisfaction with contractor’s performance.

__ Extremely Satisfied (Explanation must be provided in Comments field below) __ Satisfied __ Unsatisfied (Explanation must be provided in Comments field below)

8. Based on your experience, would you award a new contract to this contractor? Please explain.

__ Yes __ No

9. General Comments. Provide any other relevant performance information.

PART B: RESPONDENT IDENTIFICATION (to be completed by Respondent) Please provide the following information:

Organization:

Name of Person Completing Information:

Title:

Date:

Telephone:

Email Address:

Relationship to Offeror or Subcontractor (e.g., customer, subcontractor, etc.):

PART C: RETURN INFORMATION

Respondent - Completed past performance questionnaires shall be submitted with Offeror’s proposal by the submission deadline 22 July 2016 at 2:00PM Eastern Time.

Thank you for your participation.

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