CONTRACTOR PERFORMANCE ASSESSMENT
Date: Work Order/Contract Date:
Contract Name: ID Number (ITSD):
Agency/Project Name/Agency Tracking #: Contractor (Individual) & Service Area:
[ ] Final Project Assessment
Attach copy of work order, agency-contractor agreement (SOW) and
- or -
any other pertinent documents.
[ ] Interim Assessment (check one below)
[ ] Period: From ___/___/___ to ___/___/___
Return to this form and all attachments to:
[ ] Deliverable/Milestone _______________
ITSD, Procurement Services Bureau
- or -
Room 223, Mitchell Building
[ ] Re-assessment
Assessment Area Comments/Rational For Rating
Staff & Business Practices
Score the next two questions using the same scale of 1 to 5, and the same rational set forth in the performance rating criteria. A score of 5
would indicate a very positive response, and a score of 1 would indicate a very negative response.
How likely are you to select this
Is/was the contractor committed
to project success?
This assessment was completed Phone # Signature & Date:
Has the contractor reviewed this Attach any Signature (contractor) & Date:
[ ] Yes comments,
[ ] No rebuttals, etc.
Department Director Signature & Date:
An agency may re-assess after receiving comments from the contractor. If the agency does a re-assessment, a new Contractor Performance
Assessment must be completed and returned with first assessment.