A07_S4_PAST_PERFORMANCE_QUESTIONNAIRE_FORM.docx
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- Attached to
- US Military HIV Research Program (MHRP)
- Solicitation number
- W81XWH-17-R-0033
- Issued by
-
Department of the Army Medical Command
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past performance questionare
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PAST PERFORMANCE QUESTIONNAIRE FORM
YOUR NAME & TITLE
YOUR ORGANIZATIONAL ADDRESS
TEL NO.
FAX :
E-MAIL:
CONTRACTOR’S NAME & ADDRESS
TITLE OR DESCRIPTION OF REQUIREMENT:
CONTRACT NUMBER:
CONTRACT VALUE (INCLUDING OPTIONS):
CONTRACT TYPE:
|_| FIXED PRICE |_| COST + FEE |_| COMPETITIVE
|_| NON-COMPETITIVE |_| SET-ASIDE |_| SEALED BID |_| NEGOTIATED
CONTRACT AWARD & COMPLETION DATE:
| PAST PERFORMANCE ELEMENT |
| RATING |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| NA |
| 1. | Contractor demonstrated a thorough understanding of technical requirements of the contract/task. |
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Comments:
| 2. | Contractor anticipated/identified and resolved problems effectively. |
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Comments:
| 3. | Contractor managed and directed resources (i.e. personnel, subcontractors, equipment, etc.) effectively. |
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Comments:
| 4. | Contractor provided the necessary skilled personnel to perform the required work. |
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Comments:
| 5. | Contractor retained the necessary skilled personnel and maintained a low turnover rate. |
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Comments:
| 6. | Contractor met scheduled contract delivery dates. |
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Comments:
| 7. | Contractor provided accurate, complete and high quality deliverables. |
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Comments:
| 8. | Contractor complied with the terms of the contract. |
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Comments:
| 9. | Contractor was diligent in forecasting and controlling contract cost. |
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Comments:
| 10. I would recommend award to this contractor again. |
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Comments:
| 1 |
| Outstanding (Explanation must be provided in comments above) |
| PLEASE RETURN COMPLETED RESPONSE TO: |
U.S. Army Medical Research Acquisition Activity Contract Specialist: John Fitzsimmons E-MAIL: john.l.fitzsimmons8.civ@mail.mil Phone: 301-619-8435
| 2 |
| Good |
| 3 |
| Acceptable |
| 4 |
| Marginal (Explanation must be provided in comments above) |
| 5 |
| Unacceptable (Explanation must be provided in comments above) |
| NA |
| No Knowledge of This Element |
Adjectival ratings definitions to be used in your response:
Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.
Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.
Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective
No Knowledge of This Element: No knowledge of this element or does not apply to meeting contractual requirements
SOURCE SELECTION SENSITIVE – SEE FAR 2.101 AND 3.104
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