Past Performance Questionnaire


The Great Plains Regional Contracting Office (GPRCO), Fort Sam Houston, Texas is conducting a commercial item acquisition. Please complete the following questionnaire to assist our evaluation of the contractors past performance and return to the attention of Mr. James Metzger at fax number (210) 916-1750, or email completed questionnaire to: [email protected]


Name of Contractor being evaluated: ______________________________________________________

1. How long has your company/organization had a contract with this contractor?___________________

2. Have there been late deliveries or other unsatisfactory performance resulting in additional contractual or administrative costs?

Yes _______ No _______

If yes, explain ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Quality of Service compliance with contract statement of work requirement? (See following page for rating system.)

(1) Superior___ (2)Satisfactory___ (3)Marginal___ (4)Unsatisfactory___

If other than Satisfactory, explain how the overall performance exceeds or does not meet contractual requirements. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________

4. Business/Customer Relations - Effective management; successfully managed services; reasonable/cooperative behavior; flexible; business-like concern for customers interest.

(1) Superior___ (2)Satisfactory___ (3)Marginal___ (4)Unsatisfactory___

If other than Satisfactory, explain how the overall performance exceeds or does not meet contractual requirements. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________


Rating System:
(1) Superior Overall performance exceeds contractual requirements and gives extra benefits to the customer. Problems, if any, were promptly corrected without negative impact to the customer.
(2) Satisfactory Performance meets contractual requirements. The contractual performance contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
(3) Marginal - Performance does not meet some contractual requirements. The contractors proposed actions to correct any problems appear only marginally effective or were not fully implemented.
(4) Unsatisfactory Performance does not meet most contractual requirements. The contractual performance contains serious problem(s) for which the contractors corrective actions appear or were ineffective.

Signature: _______________________ Date: _____________________________

Print Name: ______________________ Company: _________________________

Title: ___________________________ Telephone: _________________________

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