Attachment A.docx
DOCX document 23 KB Posted
- Attached to
- Family Health History Tool Community-based Dissemination and Integration in HRSA-funded Health Centers.
- Solicitation number
- 10-250-SOL-00084ebd-1R
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Attachment A - Contractor Interim/Final Performance Report
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Other files
| File | Type | Posted |
|---|---|---|
| Responses to questions.docx | DOCX document | |
| Attachment F.doc | DOC document | |
| Attachment E.docx | DOCX document | |
| Attachment B.docx | DOCX document | |
| Attachment C.docx | DOCX document | |
| Invitational Letter for RFC.docx | DOCX document | |
| Attachment D.docx | DOCX document | |
| RFP 10-250-00084-ebd-1R dtd 05-28-10.docx | DOCX document | |
| Attachment G .docx | DOCX document |
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ATTACHMENT A
Health Resources and Services Administration Contractor Past Performance Evaluation
1. FINAL REPORT _____ INTERIM REPORT _____ (Check one)
2. REPORTING PERIOD: (From) (To)
3. CONTRACTING OFFICER:
4. CONTRACT NUMBER:
5. CONTRACTOR NAME:
DEPARTMENT/ COMPONENT:
ADDRESS:
CITY: STATE: ZIP CODE:
6. CONTRACT AWARD DATE:
CONTRACT EXPIRATION DATE:
7. CONTRACT VALUE : $
8. DESCRIPTION OF REQUIREMENT (Title):
9. RATINGS
Circle the number that corresponds to the rating for each category (see attached Rating Guidelines), and provide comments to support the rating.
QUALITY OF PRODUCT OR SERVICE Rating 0 1 2 3 4 5 Comments:
COST CONTROL Rating 0 1 2 3 4 5
Contractor Past Performance Evaluation
TIMELINESS OF PERFORMANCE Rating 0 1 2 3 4 5
BUSINESS RELATIONS Rating 0 1 2 3 4 5
10. SUBCONTRACTS
Are subcontracts involved? Yes No (Circle one) Comments: [Briefly summarize the quality of performance of major subcontractors. This information serves two purposes: (1) it provides some insight into the contractor’s effectiveness in managing its subcontractors; and (2) it provides information that may be useful for future procurements when evaluating the past performance of offerors that have only performed as subcontractors. ]
11. KEY PERSONNEL
PROJECT MANAGER/PRINCIPAL INVESTIGATOR (name):
| Health Resources and Services Administration |
| Contractor Past Performance Evaluation |
KEY PERSON (name) :
KEY PERSON (name) :
12. CUSTOMER SATISFACTION
Is/was the contractor committed to customer satisfaction?
Yes No (Circle one)
Would you recommend selection of this firm again?
Yes No (Circle one)
13. PROJECT OFFICER (name) :
SIGNATURE: ____________________________________Date_________ Phone: FAX:
Internet Address:
14. CONTRACTING OFFICER CONCURRENCE: (Initial) __________ Date:
Contractor Past Performance Evaluation
15. CONTRACTOR’S REVIEW:
| Were comments or additional information provided? | ||
| Yes | No | (Circle one) |
If yes, they are:
| On file in: | |||
| ________________________ | _____________ | ||
| (Location) | (Phone) | ||
| Attached: _____ (Check if attached) |
| CONTRACTOR’S REPRESENTATIVE: | (name) | |
| SIGNATURE: ____________________________________Date__________ | ||
| Phone: | FAX: | |
| Internet Address: |
16. AGENCY REVIEW:
| Were contractor comments reviewed at a level above the contracting officer? | ||
| Yes | No | (Circle one) |
| If yes, Agency Decision is: | |||
| On file in: | |||
| _____________________ | _____________ | ||
| (Location) | (Phone) | ||
| Attached: _____ (Check if attached) |
17. SUMMARY RATINGS:
QUALITY: _______ COST CONTROL: _______
TIMELINESS OF
PERFORMANCE: _______ BUSINESS RELATIONS: _______
| 18. CONTRACTING OFFICER | (name): | |
| SIGNATURE: ____________________________________Date__________ | ||
| Phone: | FAX: | |
| Internet Address: |
Rating Guidelines
Quality of Product or Service 0 = Unsatisfactory 1 = Poor 2 = Fair 3 = Good 4 = Excellent 5 = Outstanding
| Unsatisfactory |
| Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements. |
| Poor |
| Overall compliance requires significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Overall compliance requires minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or very minimal, quality problems, and the Contractor has met the contract requirements. |
| Excellent |
| There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example for others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent.” |
Cost Control 0 = Unsatisfactory 1 = Poor 2 = Fair 3 = Good 4 = Excellent 5 = Outstanding
| Unsatisfactory |
| Ability to manage cost issues is jeopardizing performance of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, this level of ability to manage cost issues constitutes a significant impediment in consideration for future awards. |
| Poor |
| Ability to manage cost issues requires significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Ability to control cost issues requires minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or very minimal, cost management issues and the Contractor has met the contract requirements. |
| Excellent |
| There are no cost management issues and the Contractor has exceeded the contract requirements, achieving cost savings to the Government. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where the contractor achieved cost savings and performance clearly exceeds the performance levels described as "Excellent.” |
Timeliness of Performance
| Unsatisfactory |
| Delays are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards. |
| Poor |
| Delays require significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Delays require minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or minimal, delays that impact achievement of contract requirements. |
| Excellent |
| There are no delays and the contractor has exceeded the agreed upon time schedule. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent.” |
Business Relations
| Unsatisfactory |
| Response to inquiries and/or technical, service, administrative issues are not effective. If not substantially mitigated or corrected it should constitute a significant impediment in considerations for future awards. |
| Poor |
| Response to inquiries and/or technical, service, administrative issues are marginally effective. |
| Fair |
| Response to inquiries and/or technical, service, administrative issues are somewhat effective. |
| Good |
| Response to inquiries and/or technical, service, administrative issues are consistently effective. |
| Excellent |
| Response to inquiries and/or technical, service, administrative issues exceed Government expectation. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent.” |
OMB CLEARANCE NO. 9000-0142 SOURCE SELECTION INFORMATION CONFIDENTIAL
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