Past Performance Questionnaire (Federal Evaluation Reference)

PAST PERFORMANCE QUESTIONNAIRE

Federal Government Contractor Evaluation Reference

TO THE CONTRACTOR'S REFERENCE:

This questionnaire is being sent to you as a government official familiar with [CONTRACTOR NAME]'s performance on a federal contract. Your objective, factual responses are essential to our agency's evaluation of this contractor's qualifications for upcoming federal opportunities.

Deadline for Response: [__/__/____]
Return Address (Email Preferred):

Email to Contracting Officer:
[________________________________]
[________________________________]
[________________________________]

CC to Offeror:
[________________________________]
[________________________________]

Important: Please provide your response within 10 to 15 business days. Incomplete or unsigned questionnaires may not be considered in the evaluation. If you cannot complete this form, please notify the offeror and contracting officer immediately.

PART I: RESPONDENT INFORMATION

Your Name and Title:
[________________________________]

Your Organization:
[________________________________]

Position/Role During Contract Period:
[________________________________]

Telephone (Business):
[________________________________]

Email Address:
[________________________________]

Relationship to Contractor:
☐ Contracting Officer (CO)
☐ Contracting Officer's Representative (COR)
☐ Point of Contact (POC)
☐ Government Project Manager
☐ Quality Assurance Evaluator
☐ Other (specify): [________________________________]

Your Authority to Evaluate: I certify that I have direct knowledge of the contractor's performance on the contract(s) referenced below and am authorized to provide this assessment.

Signature: [________________________________] Date: [__/__/____]

PART II: CONTRACT REFERENCE INFORMATION

Contract Number (PIID):
[________________________________]

Modification Number (if applicable):
[________________________________]

Contract Type:
☐ Fixed-Price (FFP)
☐ Cost-Plus-Fixed-Fee (CPFF)
☐ Cost-Plus-Incentive-Fee (CPIF)
☐ Time & Materials (T&M)
☐ Indefinite Delivery/Indefinite Quantity (IDIQ)
☐ Other: [________________________________]

Contract Award Value:
[________________________________]

Contract Final Value (including all modifications):
[________________________________]

Period of Performance (Initial):
From [__/__/____] to [__/__/____]

Period of Oversight/Supervision:
From [__/__/____] to [__/__/____]

Brief Description of Work Performed:
[________________________________]
[________________________________]
[________________________________]

Contracting Agency:
[________________________________]

Contracting Office:
[________________________________]

Total Dollar Value of Task Orders/Delivery Orders (if IDIQ):
[________________________________]

PART III: RATING SCALE

The following rating scale reflects industry-standard performance metrics used in the Contractor Performance Assessment Reporting System (CPARS) and federal source selection. Your ratings will directly impact the contractor's overall performance standing.

Rating Definitions:

☐ Exceptional — Performance substantially exceeds contract requirements. The contractor demonstrates innovation, cost efficiency, and full compliance. Sustained excellence across all evaluation factors.

☐ Very Good — Performance exceeds contract requirements in most areas. Demonstrates strong technical capability, timeliness, and communication. Minor deficiencies that did not impact mission success.

☐ Satisfactory — Performance meets contract requirements. Contractor delivers acceptable quality, stays on schedule, and maintains adequate communication. Expected baseline performance.

☐ Marginal — Performance meets some but not all contract requirements. Deficiencies exist in technical quality, schedule, cost control, or responsiveness. Issues were resolved but caused delays or rework.

☐ Unsatisfactory — Performance fails to meet contract requirements. Significant deficiencies in technical quality, schedule compliance, cost control, or management. Problems were not adequately resolved or required substantial government intervention.

☐ Not Applicable — Cannot evaluate due to limited involvement or contract type.

PART IV: EVALUATION FACTORS

1. TECHNICAL QUALITY / CONFORMANCE TO CONTRACT REQUIREMENTS

Definition: Quality of deliverables, workmanship, compliance with specifications, and adherence to technical standards and requirements.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (provide specific examples):
[________________________________]
[________________________________]
[________________________________]

2. SCHEDULE PERFORMANCE

Definition: On-time delivery of deliverables, adherence to milestones, responsiveness to urgent requests, and ability to meet aggressive timelines.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (include any delays, compression, or extended performance periods):
[________________________________]
[________________________________]
[________________________________]

3. COST CONTROL

Definition: Budget accuracy, cost tracking, prevention of cost overruns, billing accuracy, and value for money delivered.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (include final contract cost vs. estimated, any overruns or underruns):
[________________________________]
[________________________________]
[________________________________]

4. MANAGEMENT / RESPONSIVENESS

Definition: Communication, coordination, problem-solving, issue resolution speed, management depth, and overall professionalism. Includes government relations and change management.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (describe contractor's responsiveness to direction, escalation procedures, and team interaction):
[________________________________]
[________________________________]
[________________________________]

5. SMALL BUSINESS UTILIZATION (if applicable)

Definition: For prime contractors: achievement of small business subcontractor goals, genuine engagement of certified small businesses, and compliance with subcontracting plan.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (include percentage of work to small businesses, diversity of subcontractors):
[________________________________]
[________________________________]
[________________________________]

6. REGULATORY COMPLIANCE

Definition: Compliance with labor laws, environmental regulations, safety requirements, cybersecurity standards, data protection, FAR clauses, and applicable agency regulations.

Your Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (note any findings, incidents, corrective actions, or compliance inspections):
[________________________________]
[________________________________]
[________________________________]

7. PROBLEMS ENCOUNTERED & RESOLUTION

Definition: If performance problems occurred, describe the nature, severity, contractor's response, and adequacy of corrective action.

Were any significant problems encountered during contract performance?
☐ Yes
☐ No
☐ Minor issues only

If Yes, describe problem(s), impact, and contractor's corrective action:
[________________________________]
[________________________________]
[________________________________]

Contractor's Responsiveness to Corrective Action Requests:
☐ Immediate & Effective
☐ Timely
☐ Slow or Inadequate
☐ Not Applicable

8. KEY PERSONNEL PERFORMANCE

Definition: Performance of the contractor's proposed key personnel, project manager, and technical lead. Include leadership stability and staff continuity.

Key Personnel/Project Manager:
[________________________________]

Performance Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory
☐ Not Applicable

Comments (note any staffing changes, performance issues, or exceptional contributions):
[________________________________]
[________________________________]
[________________________________]

PART V: OVERALL PERFORMANCE RATING

Based on all evaluation factors above, provide your overall assessment:

Overall Rating:
☐ Exceptional
☐ Very Good
☐ Satisfactory
☐ Marginal
☐ Unsatisfactory

Brief Summary of Overall Performance:
[________________________________]
[________________________________]
[________________________________]

PART VI: FUTURE WORK RECOMMENDATION

Would you award future work to this contractor under similar circumstances?

☐ Yes — I would confidently recommend continued performance on similar future contracts.

☐ Maybe / Conditionally — Future work is possible with specified improvements or conditions (describe below).

☐ No — I would not recommend this contractor for future federal work.

Please explain your recommendation:
[________________________________]
[________________________________]
[________________________________]

PART VII: GENERAL COMMENTS

Additional comments regarding contractor performance, organizational capability, or recommendations for improvement:
[________________________________]
[________________________________]
[________________________________]
[________________________________]

PART VIII: CERTIFICATION AND SIGNATURE

I certify that the information provided in this questionnaire is accurate and complete to the best of my knowledge. I have direct, personal knowledge of the contractor's performance on the contract(s) referenced above and am an authorized government representative.

I understand that this questionnaire will be used in the contractor's performance evaluation and source selection process for federal contracts and may be reviewed by government officials and the contractor.

Respondent Signature:
[________________________________]

Printed Name & Title:
[________________________________]

Organization:
[________________________________]

Date:
[__/__/____]

Telephone:
[________________________________]

Email:
[________________________________]

RETURN INSTRUCTIONS

Completion: Complete all sections of this questionnaire. Unsigned or substantially incomplete questionnaires may not be considered.

Deadline: Return by [__/__/____]

Submission Method (Email Preferred):

1. Email to Government Contracting Officer:
   - Address: [________________________________]
   - Subject Line: "Past Performance Reference – [CONTRACTOR NAME] – [PIID]"

2. CC to Offeror at:
   - Address: [________________________________]

3. If Email is Unavailable (Mail):
   - Address: [________________________________]
   - Attn: [________________________________]

Confidentiality Note: This questionnaire is solicited feedback on contractor performance. Keep responses factual, objective, and evidence-based.

ATTACHMENTS

Please include the following if available:

☐ Contract performance summary or final report
☐ List of key personnel assigned to contract
☐ Copies of any performance evaluation reports
☐ Relevant correspondence or quality assurance findings
☐ Other (specify): [________________________________]

SOURCES AND REFERENCES

• SAM.gov (System for Award Management): https://www.sam.gov — Federal contract registry and CPARS data
• CPARS (Contractor Performance Assessment Reporting System): https://www.cpars.gov — Government-maintained contractor performance database
• FAR Subpart 15.3 (Source Selection and Evaluation): Federal Acquisition Regulation requirements for past performance evaluation
• FAR 15.305(a)(2): Specific regulatory language on past performance evaluation factors
• FAR Subpart 42.15 (Contractor Performance Information): Reporting and documentation of contractor performance
• GSA Contract Performance Standards: https://www.gsa.gov — Guidelines for evaluating contractor performance