PAST PERFORMANCE QUESTIONNAIRE Attachment 5 Name of Offeror: Name of Customer: Contract Number: Contract Value: Period of Performance: Functional Area (s): NAICS Code (s): The ratings below are supplied by the organization identified above, and submitted by the offeror with their proposal. Answers to Questions 1-6 are based on information obtained from the named organization, not the offeror. Ratings to be used are: Outstanding = 5; Excellent = 4; Good = 3; Fair = 2; Poor = 1, and Unsatisfactory = 0. Ratings should be supported with the appropriate comments.

Use only whole numbers. Anything lower than an overall rating of 3 will constitute an unacceptable level of risk. (See Section L. 3. 7. ) Neutral ratings for past performance will be assigned when there is no past performance history available.

Neutral ratings will not penalize the offeror and will result in their offer being further evaluated. 1. Quality of Product or Service Rating: Comments. 2.

Timeliness of Performance Rating: Comments: 3. Business Relations: Rating: Comments: 4. Compliance with Price Estimates: Rating: Comments: 5. Customer Satisfaction: Rating: Comments: 6. Overall Performance: Rating: Comments: 7. Would you do business with this company again? Yes / No 8.

Questionnaire completed by: Name of Employee Title Mailing Address (Street Address) (City, State, Zip) Telephone and Fax Numbers E-Mail Address Signature of Employee Date RATING GUIDELINES Summarize contractor performance in each of the rating areas. Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent), 5 (Outstanding). Use the following instructions as guidance in making these evaluations. Criteria: Quality of Product or Service Price Control Timeliness of Performance Business Relations o o Compliance with contract requirements o Accuracy of reports o Effectiveness of personnel o Technical excellence o Record of forecasting and controlling target prices o Current, accurate and complete billings o Relationship of negotiated prices to actuals o Price efficiencies o Met interim milestones o Reliability o Responsive to technical direction o Completed on time including wrap-up and contract administration o Met delivery schedules o No liquidated damages assessed o Effective management, including subcontracts o Reasonable / cooper -ative behavior o Responsive to contract requirements o Notification of problems o Flexibility o Pro-active vs.

reactive o Effective small / small disadvantaged business subcontracting program 0 - Unsatisfactory Non conformance's are jeopardizing the achievement of contract requirements, despite use of Agency resources Ability to manage price issues is jeopardizing performance of contract requirements, despite use of Agency resources Delays are jeopardizing performance of contract requirements, despite use of Agency resources Response to inquiries, technical / service /admin-istrative issues is not effective 1 - Poor Overall compliance requires major Agency resources to ensure achievement of contract requirements Ability to manage price issues requires major Agency resources to ensure achievement of contract requirements Delays require major Agency resources to ensure achievement of contract requirements Response to inquiries, technical / service /admin- istrative issues is marginally effective 2 - Fair Overall compliance requires minor Agency resources to ensure achievement of contract requirements Ability to control price issues requires minor Agency resources to ensure achievement of contract requirements Delays require minor Agency resources to ensure achievement of contract requirements Response to inquiries, technical / service /admin- istrative issues is somewhat effective 3 - Good Overall compliance does not impact achievement of contract requirements Management of price issues does not impact achievement of contract requirements Delays do not impact achievement of contract requirements Response to inquiries, technical / service /admin- istrative issues is usually effective 4 - Excellent There are no quality problems There are no price management issues There are no delays Response to inquiries, technical / service /admin- istrative issues is effective 5 - Outstanding The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as Excellent.