ATTACHMENT C
PAST PERFORMANCE EVALUATION FORM
PSC-22-06

Offeror Name: 	

Performance Element
(See Description p. 2)	Excellent*
	
Good	
Acceptable	
Poor	
Unacceptable**	
Quality of Services/ Work						
Timeliness of Performance						
Cost Control						
Business Relations						
Customer Satisfaction						

1.	Name of Evaluating Organization:  	

2.	Name & Title of Evaluator:  	

3.	Telephone Number of Evaluator:  	

4.	E-mail address of Evaluator:  	

5.	Signature of Evaluator:  	

Date:  	

6.	Describe type of service received:  	

7.	Contract Number  	

Contract Amount   	

8.	Contract Period of Performance  	
*Remarks on Excellent Performance: Provide data supporting this observation. (Continue on separate sheet if needed)

** Remarks on Unacceptable Performance: Provide data supporting this observation. (Continue on separate sheet if needed)

RATING GUIDELINES

Summarize Contractor performance in each of the rating areas. Assign each area a rating of 0 (Unacceptable), 1 (Poor), 2 (Acceptable), 3 (Good), 4(Excellent), or ++ (Plus). Use the following instructions as guidance in making these evaluations.

Quality		Timeless	Business	
Product/Service	Cost Control	of Performance	Relations	
-Compliance with	-Within budget (over/	-Meet Interim milestones	-Effective management	
contract requirements	under target costs)	-Reliable	-Businesslike correspondence	
-Accuracy of reports	-Current, accurate, and	-Responsive to technical	-Responsive to contract	
-Appropriateness of	complete billings	directions	requirements	
personnel	-Relationship of negated	-Completed on time,	-Prompt notification of contract	
-Technical excellence	costs to actual	including wrap-up and	problems	
	-Cost efficiencies	-contract administration	-Reasonable/cooperative	
	-Change order issue	-No liquidated damages	-Flexible	
		assessed	-Pro-active	
			-effective contractor	
recommended solutions
-Effective snail/small disadvantaged business Subcontracting program

0. Zero	Nonconformances are comprises the achievement of contract	Cost issues are comprising performance of contract	Delays are comprising
the achievement of contract	Response to inquiries, technical/ service/administrative issues is	
	requirements, despite use of Agency resources	requirements.	requirements, Despite use of Agency resources.	not effective and responsive.	
1, Unacceptable	Nonconformances require major Agency resources to ensure achievement of contract requirements.	Cost issues require 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/administrative issues is marginally effective and responsive.	
2. Poor	Nonconformance require minor	Costs issues require minor	Delays require minor	Responses to inquiries, technical/	
	Agency resources to ensure achievement of contract requirements.	Agency resources to ensure achievement of contract requirements.	Agency resources to ensure achievement of contract requirements.	service/administrative issues is somewhat effective and responsive.	
3. Acceptable	Nonconformances do not impact	Cost issues do not impact	Delays do not impact	Responses to inquires, technical/	
	achievement of contract requirements.	achievement of contract requirements.	achievement of contract requirements.	service/administrative issues is usually effective and responsive.	
4. Good	There are no quality problems.	There are no cost issues.	There are not delays.	Responses to inquiries, technical/	
				service/administrative issues is effective and responsive,	
5. Excellent	The contractor has demonstrated an exceptional performance level in some or all of the above categories.