Attachment 2 - Past Performance Assessment Questionnaire.DOC

Past Performance Assessment Questionnaire

Please provide your candid responses. The information that you provide will be used in the award of a federal contract action. 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. Please return the completed Questionnaire to the Government’s POCs identified below by 17 April 2024 at 3:00 PM Eastern Time (ET).

Rating Definitions:

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective action taken by the contractor was highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance eof the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious probme for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

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

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Offeror’s Past Performance Reference POC – Respondent) *Note: rationale is required for each response.

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

· Exceptional

· Very Good

· Satisfactory

· Marginal

· Unsatisfactory

Rationale: _________________________________________________________

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

· Satisfactory

· Marginal

· Unsatisfactory

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Satisfactory

· Marginal

· Unsatisfactory

Rationale: __________________________________________________________

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

· Satisfactory

· Marginal

· Unsatisfactory

Rationale: __________________________________________________________

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Satisfactory

· Marginal

· Unsatisfactory

Rationale: __________________________________________________________

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

Comments: _________________________________________________________

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

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:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Government’s POCs identified above.

Thank you for your assistance.