Attachment_2_-_Past_Performance_Questionnaire_(Fillable_Form).pdf

PAST PERFORMANCE QUESTIONNAIRE

CONTRACTOR NAME:

CONTRACTOR ADDRESS:

CONTRACT NUMBER:

CAGE CODE:

BASE $ VALUE:

1st OPTION $ VALUE:

2nd OPTION $ VALUE:

3rd OPTION $ VALUE:

4th OPTION $ VALUE:

CONTRACT AWARD DATE:

CONTRACT COMPLETION DATE:

PRIME OR SUBCONTRACTOR:

EVALUATOR NAME AND TITLE:

DATE:

PHONE:

E-MAIL:

EVALUATOR ADDRESS:

TYPE OF CONTRACT: (Check all that apply) FP FPE FP-EPA CPFF-Completion CPFF- Term CPIF CPAF ID/IQ

BOA Requirements Labor Hour T&M SBSA 8(a) SBIR Sealed Bid Negotiated Competitive Non Competitive

DESCRIPTION OF CONTRACT AND LOCATION OF THE WORK:

LIST NUMBER OF CDRs, CURE NOTICES, SHOW CAUSES ISSUED AND OTHER GOVERNMENT REMEDY ACTIONS TAKEN AND IF

CONTRACT WAS PARTIALLY OR COMPLETELY TERMINATED FOR CONVENIENCE OR DEFAULT OR PENDING ON PAGE 2.

PERFORMANCE RATING LEGEND:

5 = OUTSTANDING 4 = ABOVE AVERAGE 3 = SATISFACTORY 2 = MARGINAL 1 = UNSATISFACTORY NA= NOT APPLICABLE

PERFORMANCE RATING ELEMENTS 5 4 3 2 1 NA PERFORMANCE RATINGS ELEMENTS 5 4 3 2 1 NA

1. WORK COMPLETED ON SCHEDULE

14. INTERACTION WITHIN CONTRACTOR'S

ORGANIZATION

2. MANAGEMENT OF WORK BACKLOG

15. KEY PERSONNEL TECHNICAL

PERFORMANCE

3. WORK COMPLETED TO CONTRACT

REQUIREMENTS

16. INTERACTION WITH GOVERNMENT STAFF

4. WORK COMPLETED WITHOUT GOVERNMENT

ASSISTANCE

17. QUALITY CONTROL PLAN DEVELOPED,

IMPLEMENTED, AND EFFECTIVE

5. PROVIDED SUFFICIENT TRAINED

EMPLOYEES TO MEET REQUIREMENTS

18. RESOLVED PERFORMANCE PROBLEMS

WITHOUT GOVERNMENT INTERVENTION.

6. MANAGEMENT'S PERFORMANCE ON-SITE

19. PROPERTY CONTROL PLAN THOROUGH

AND COMPREHENSIVE

7. HOME OFFICE PROVIDED SUFFICIENT

SUPPORT AND RESOURCES

20. GOVERNMENT-FURNISHED PROPERTY

MAINTAINED AND ACCOUNTED FOR

8. CONTRACTOR EXPERIENCED AND

KNOWLEDGEABLE IN THIS TYPE OF WORK

21. SAFETY AND HEALTH PROGRAM

DEVELOPED, IMPLEMENTED, AND EFFECTIVE

9. SUBCONTRACTOR MANAGEMENT

22. CONTRACTOR MADE EFFORT TO KEEP

GOVERNMENT COSTS DOWN

10. ALL SUBMITTALS AND DOCUMENTS

TIMELY AND ACCURATE

23. CONTRACT CONCESSIONS MADE DUE TO

CONTRACTOR'S INABILITY TO PERFORM

11. SUBMITTED CHANGE ORDERS AND

PROPOSALS TIMELY

24. OVERALL CONTRACTOR PERFORMANCE

12. CONTRACTOR'S PROPOSALS REALISTIC

25. CUSTOMER SATISFACTION

13. PERFORMED CHANGE ORDERS PROMPTLY

26. WOULD YOU HIRE THIS CONTRACTOR

AGAIN IF IT WERE YOUR CHOICE

USE THE FOLLOWING PAGE FOR COMMENTS AND REASONS TO SUPPORT EVALUATION RATINGS

PAST PERFORMANCE QUESTIONNAIRE

COMMENTS AND REASONS TO SUPPORT EVALUATION RATINGS: Please identify comments and/or reasons with the performance rating element number and title. Please comment on evaluation rating elements rated above or below satisfactory. Feel free to make any comments you wish to describe this contractor's past performance and any other pertinent information.

COMMENTS: