14-75A50126R00001_RFP Att 14 Past Perfomance Questionnaire Template.docx
DOCX document 184 KB Posted
- Solicitation number
- 75A50126R00001_RFP_NPIVS_27
About this file
This is a Past Performance Questionnaire template used by HHS/OS/ASPR/CMA to evaluate prime contractor performance on the BARDA Vaccine Medical Countermeasures for Pandemic Influenza Preparedness & Response Program (Solicitation 75A50126R00001_RFP_NPIVS_27).
The template requires offerors to provide contract identification information including contract number, award date, period of performance, contract value, and type of contract, along with details on any subcontractor involvement exceeding a specified percentage threshold. Evaluation organization representatives (PCO, PM, or COR) complete the assessment portion by rating contractor performance across six key categories using a 0-5 scale (Unsatisfactory, Marginal, Satisfactory, Very Good, Exceptional, or Outstanding), with an option to mark "N/A" if insufficient knowledge exists. The evaluation criteria include: Quality of Product or Service (compliance with requirements, accuracy of reports, personnel effectiveness, technical excellence); Cost Control (cost forecasting, billing accuracy, best value delivery, cost efficiencies); Schedule (interim milestones, reliability, responsiveness to direction, on-time completion, delivery schedules); Business Relations (management effectiveness including subcontracts, cooperative behavior, problem notification, flexibility, proactive engagement, small business subcontracting); Security (physical and information security compliance); and Customer Satisfaction (commitment assessment and recommendation for future selection). Completed questionnaires are classified as Source Selection Sensitive Information and must be submitted to the Contracting Officer, Laura Saddison (Laura.Saddison@hhs.gov). The template includes detailed rating guidelines that define performance standards for each rating level with emphasis on objective, measurable performance indicators.
View the file
Other files
Show all 24
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT #14
PAST PERFORMANCE QUESTIONNAIRE
PAST PERFORMANCE QUESTIONNAIRE – APPLY TO PRIME OFFEROR:
Your assistance is requested in support of a source selection. Request a representative of the contracting organization and a technical representative, the Program Manager (PM), and the Contracting Officer’s Representative (COR), complete this questionnaire and e-mail to:
HHS/OS/ASPR/CMA
Attn: Laura Saddison, Contracting Officer Laura.Saddison@hhs.gov
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
BLOCKS 1 THROUGH 8 TO BE COMPLETED BY THE OFFEROR
1. OFFEROR NAME & ADDRESS:
2. CONTRACT NO.:
3. CONTRACT AWARD DATE:
4. PERIOD OF PERFORMANCE/COMPLETION DATE:
5. Approximate percentage of work being performed (or completed) by subcontractor(s): %
6. Information on subcontractor(s) (where more than % of work was completed by the subcontractor).
7. CONTRACT VALUE (WITH OPTIONS):
8. TYPE OF CONTRACT:
9. TITLE OF CONTRACT AND DESCRIPTION OF CONTRACT REQUIREMENTS:
BLOCKS 9 THROUGH 10F TO BE COMPLETED BY EVALUATION ORGANIZATION REPRESENTATIVE
10. EVALUATION:
a. EVALUATOR’S NAME
POSITION (PCO/PM/COR/OTHER)
ORGANIZATION
PHONE NUMBER/E-MAIL
b. MONTHS OFFEROR PERFORMANCE MONITORED BY EVALUATOR:
c. RATINGS - Please check the block beside the response code that best reflects your evaluation of the Offeror’s performance.
Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Commentary to support rating may be noted at the end of the questionnaire under ‘additional comments’.
Assign each area a rating of 0 (Unsatisfactory), 1 (Marginal), 2 (Satisfactory), 3 (Very Good), 4 (Exceptional) or 5 (Outstanding). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the Offeror to make a determination on any of the performance criteria below, please circle “N/A” (not applicable /no opinion).
A. Quality of Product or Service
| A-1. Compliance with contract requirements |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| A-2. Accuracy of reports |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| A-3. Effectiveness of personnel |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| A-4. Technical excellence |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
B. Cost Control
| B-1. Record of forecasting and controlling target costs |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| B-2. Current accurate and complete billings |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| B-3. Best value (balance of performance vs. cost). |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| B-4. Relationship of negotiated costs to actuals |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| B-5. Cost efficiencies |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
C. Schedule
| C-1. Met interim milestones |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| C-2. Reliability |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| C-3. Responsive to technical direction |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| C-4. Completed on time including wrap-up and contract administration |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| C-5. Met delivery schedules |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
D. Business Relations
| D-1. Effective management, including subcontracts |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-2. Reasonable/cooperative behavior |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-3. Responsive contract requirements |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-4. Notification of problems |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-5. Flexibility |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-6. Pro-active vs. reactive |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| D-7. Effective small/small disadvantaged business subcontracting program |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
E. Security
| E-1. Understanding of physical security compliance. |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| E-2. Compliance with communication and information security. |
| N/A |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
F. Customer Satisfaction
| F-1. The Offeror is committed to customer satisfaction |
| Yes |
| No |
| F-2. Would you recommend selection of this firm again? |
| Yes |
| No |
RATING GUIDELINES
RATING GUIDELINES
QUALITY OF PRODUCT OR
| Definition |
| Note |
| 1 – Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the Offeror’s corrective actions appear or were ineffective. |
| To justify an Unsatisfactory rating, identify multiple significant events in each category that the Offeror had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the Offeror of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters). |
| 2 – Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the Offeror has not yet identified corrective actions. The Offeror’s proposed actions appear only marginally effective or were not fully implemented. |
| To justify Marginal performance, identify a significant event in each category that the Offeror had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the Offeror of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter). |
| 3 – Satisfactory |
| Performance meets contractual requirements. The contractual performance of the element or sub- element contains some minor problems for which corrective actions taken by the Offeror appear or were satisfactory. |
| To justify a Satisfactory rating, there should have been only minor problems, or major problems the Offeror recovered from without impact to the contract/order. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that Offerors will not be evaluated with a rating lower than Satisfactory solely for not performing beyond the requirements of the contract/order. |
| 4 – Very Good |
| Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub- element being evaluated was accomplished with some minor problems for which corrective actions taken by the Offeror were effective. |
| To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified. |
| 5 – Exceptional |
| Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub- element being evaluated was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective. |
| To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified. |
File details come from the government source that posted it. Updated .