Section_J _Atch_G _PP_Questionaire.pdf

ATTACHMENT G: PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire within 15 days. Thank you.

PART I. (To be completed by the Offeror)

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

CAGE Code:

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

Organization:

Name:

Title:

Date:

Telephone Number Address:

Fax Number:

E-mail Address:

C. RESPONDENT IDENTIFICATION

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFERORS’S REPRESENTATIVE

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

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:

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

Exceeds Contractual Requirements (Explanation must be provided in

Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship.

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables, including the Administrative Aspects of Performance.

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

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

PART III. RETURN INFORMATION

PLEASE NOTE: When completed, please send by electronically via email to Ms.

Jennifer Kotar, (Contract Specialist) email: jennifer.a.kotar.ctr@mail.mil Thank you for your assistance.

D. Overall Satisfaction.

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

F. Other Information Sources. Please provide the following information: