Attachment_3_-_Past_Performance_Questionnaire.pdf

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 to the Contracting Officer, Raymond Padgett III at raymond.padegtt5.civ@mail.mil within 3 days of receipt.

Adjectival Rating Definitions:

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 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: ____________________________ mailto:raymond.padegtt5.civ@mail.mil

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name: ________________________________________________________________ Title: _________________________________________________________________ Date: _________________________________________________________________ Telephone Number: _____________________________________________________ Address: ______________________________________________________________ E-mail Address: ________________________________________________________

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

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

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

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

Acceptable

C. Timeliness of Performance for Services and Product Deliverables.

Acceptable

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

Acceptable

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

Acceptable

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

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:

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 via e-mail to the Contracting Officer at raymond.padgett5.civ@mail.mil.

Thank you for your assistance.

mailto:raymond.padgett5.civ@mail.mil