EXHIBIT_A_-_PAST_PERFORMANCE_QUESTIONNAIRE.pdf

EXHIBIT #1

SOLICITATION #W81XWH-19-Q-0183

FOR OFFICIAL USE ONLY

PAST PERFORMANCE EVALUATION – QUESTIONNAIRE FORM

Part 1 – Contract Information / Evaluation Definitions

Contractor Referenced Organization POC Name / Title Contract Title Contract Number Contract Type Period of Performance Award Value Scope of Work

The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract.

Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall 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.

PART 2. EVALUATION (To be completed by Point of Contact – Respondent)

Quality of Service Rating:

Outstanding Good Acceptable Marginal Unsatisfactory

Comments:

Effectiveness of Project Management Rating:

Good Acceptable Marginal

Schedule Rating:

Good Acceptable Marginal Unsatisfactory

A. Quality of Service - Did the contractor conform to the specifications of your requirement and meet your needs? Are the deliverables of a good quality?

B. Effectiveness of Project Management - Were subcontractors and Key Personnel managed effectively to meet your requirement? Were project oversight, planning, and staffing successful in meeting your needs?

C. Schedule - Were performance/deliverables on time?

Cost Control Rating:

Good Acceptable Marginal

Business Relations Rating:

Good Acceptable Marginal

Customer Satisfaction Rating:

Good Acceptable

D. Cost Control - Did the contractor operate within the budget proposed without significant cost under/over-runs?

E. Business Relations - Does the staff operate professionally? Is communication efficient and effective?

F. Customer Satisfaction - Were any complaints filed within your organization against this contractor?

Would you recommend this vendor to others, and if so, why?

Marginal

PART 3. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contract Specialist identified in the cover letter.

Thank you for your assistance.

Printed Name :

Signature Date

G. G. Overall Past Performance comments for this reference: