Attachment A - Past Performance Survey.docx

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Attached to
Health Data Modeling and Simulation Software as a Service Federal contract opportunity
Solicitation number
12-233-SOL-00090
Issued by
Department of Health and Human Services Program Support Center

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Attachment A - Past Performance Survey (Word Document)

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Attachment B_12-233-SOL-00090_0001_Q A.pdf PDF
Attachment C_12-233-SOL-00090_0001_Page 4_Revised.pdf PDF
12-233-SOL-00090.pdf PDF

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

PROGRAM SUPPORT CENTER

Past Performance Survey

12-233-SOL-00090

Contractor Name:

CLIENT INFORMATION

|_| Commercial Client
|_| Federal Client
Client Name:
Client Address:

City

State

Zip Code

Project Name:
Contract Number(s):
Total Contract Value:
Performance Period:
Teaming Partner(s):
Government or Commercial Project Manager Contact
Alternate Government or Commercial Project Manager Contact
Name:
Name:
Title:
Title:
Phone number:
Phone number:
Fax number:
Fax number:
E-mail address:
E-mail address:

SPECIFIC PERFORMANCE

Instructions: This part consists of open-ended questions to determine the scope, complexity, and relevance of the project to the current requirement. Please answer the questions concisely and to the best of your knowledge.

1.
Describe the overall project type the contractor provided.
2.
Describe the end goal/end product and result.
3.
Describe the long-term program development involved in performing this task.
4.
Describe the level of planning and staffing contractor was required to perform and if they met the contracts exceptions.
5.
Describe the average timeline involved in completing this project and if contractor met that timeline within reason.

Attachment A – Past Performance Health Data Modeling and Simulation Software as a Service

SOURCE SELECTION SENSITIVE

NOT FOR PUBLIC RELEASE

PAST PERFORMANCE RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Comments to support ratings may be noted on last page. The Government will assess an overall past performance rating for each reference contacted. The overall ratings of each reference will then be combined to arrive at a final past performance rating that will be assigned points based upon the following rating scheme:

RATINGS ARE DEFINED AS FOLLOWS:

DefinitionDescription
ExcellentThe Contractor demonstrates an excellent performance level in all categories. There have been no performance problems and the Contractor has demonstrated initiative to enhance/exceed contractual requirements and objectives. The Contractor also has maintained an excellent Contractor/Government relationship throughout contract performance
GoodThere are no quality of service problems; no cost/price issues; and no delays. Responses to inquiries and technical/service administrative issues are consistently effective and responsive. Non-conformance does not impact achievement of contract requirements.
AcceptableNon-conformances are minor and have little impact in achievement of contract requirements, requires minor intervention by Government personnel to resolve issues.
MarginalNon-conformances are impacting achievement of contract requirements, requires substantial intervention by Government personnel to resolve issues.

Past Performance Survey Unacceptable Non-conformances are compromising the achievement of contract requirements, despite substantive intervention by Government personnel.

PART 1: GENERAL PERFORMANCE

INSTRUCTIONS: PLEASE CHECK THE APPROPRIATE RATING

Quality of Service
Excellent
Good
Acceptable
Marginal
Unacceptable
N/A
1. Compliance with contract requirements
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2. Accuracy of Reports
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3. Effectiveness of Personnel
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4. Technical Excellence
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5. Record of conforming to specifications and standards of good workmanship
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6. Ability to provide services nationwide, including small and rural communities
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Cost Control
Excellent
Good
Acceptable
Marginal
Unacceptable
N/A
1. Record of forecasting and controlling target costs
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2. Current, accurate, and complete billings
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3. Relationship of negotiated costs to actual
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4. Cost efficiencies
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Timeliness of Performance
Excellent
Good
Acceptable
Marginal
Unacceptable
N/A
1. Met interim milestones
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2. Reliability
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3. Responsive to technical direction
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4. Completed on time including wrap up
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5. Met delivery schedules
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6. Amount of Liquidated Damages (Excellent=Low or None, Unacceptable= High)
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Business Relations
Excellent
Good
Acceptable
Marginal
Unacceptable
N/A
1. Effective Management, including subcontracts
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2. Reasonable/cooperative behavior
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3. Responsive to contract requirements
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4. Notification of problems
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5. Flexibility
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6. Pro-active vs. Reactive
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7. Effective small/small disadvantage business subcontracting program
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8. History of staff turnover
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Customer Satisfaction
Excellent
Good
Acceptable
Marginal
Unacceptable
N/A
1. Commitment to customer satisfaction
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2. Would you recommend selection of this firm again?
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3. Overall Rating of Contractor
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ADDITIONAL COMMENTS:

_______________________________________________________________________
Name and Signature of ReferenceDate

File details come from the government source that posted it. Updated .