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PAST PERFORMANCE QUESTIONAIRE
Contractor Name
Solicitation Number HSCG23-12-Q-PJH033
Name of Rating Party Raters Phone:
Contract Type Raters Email:Contract Number
Place of Performance
Period of Performance
Contract Value
The requirement for which this Past Performance Questionnaire is being submitted is concerned
primarily with the United States Coast Guard (USCG) Electronic Wireless Access Lock System
Requirement.
Performance Grades:
ExceptionalContractors performance significantly exceeded most or all contract
requirements. The contractual performance of the element or sub element being assessed
was accomplished with few minor problems for which corrective actions taken by the
Contractor were highly effective.
Very GoodPerformance meets contractual requirements and exceeds some
requirements to the Governments benefit. The Contractual performance of the elementor sub-element being assessed was accomplished with some minor problems for which
corrective actions taken by the Contractor were effective.
SatisfactoryPerformance meets contractual requirements. The contractual
performance of the element or sub-element may contain some minor problems for which
corrective actions taken by the Contractor appear to be or were satisfactory.
MarginalPerformance does not meet some contractual requirements. The contractual
performance of the element or sub-element being assessed reflects a serious problem for
which the Contractor has not yet identified corrective actions. The contractors proposedactions appear only marginally effective or were not fully implemented.
UnsatisfactoryPerformance 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 serious problem(s) for which the contractors corrective action(s) appear
or were ineffective.
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Please circle the appropriate performance grade in each of the areas below for the
contractors past performance as based on comments provided by the customer.
Please provide any additional comments as well.
1.
Commitment to Customer Satisfaction: To what degree was the Contractorconsidered responsive to and cooperative with customer personnel?
Unsatisfactory Marginal Satisfactory Very Good Exceptional
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2. Quality of Goods and Services: This area of the questionnaire deals with adherence
to the contract requirements, to include appropriateness of personnel, technical
excellence, product quality, and overall compliance with Contract Terms andConditions.
Unsatisfactory Marginal Satisfactory Very Good Exceptional
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3. Timeliness of Performance: The Contractors ability to meet milestones and
delivery schedule, to include responsiveness to technical direction, completion of
efforts on time, planning, monitoring, wrap up and administration.
Unsatisfactory Marginal Satisfactory Very Good Exceptional
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4. Has the Contractor ever been given a cure notice, a show cause notice, suspension of
progress payments, or other letters directing the correction of a performance problem?
Yes______________ No_____________
If Yes, please explain:
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5. Based on this Contractors overall performance, would you award this Contractor
another Government Contract?
Yes______________ No_____________ Not Sure_________________
If no or not sure, please explain:
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Thank you for your time. Please return this survey via email to the Contract Specialist at
mailto:[email protected]:[email protected]:[email protected]