Attachment_5_-_Past_Performance_Questionnaire.doc.rtf

Attachment 5 - PAST PERFORMANCE QUESTIONAIRE 16-223-SOL-00016

Please complete the following questionnaire and return via email to the attention of:

Natalie Mitchell, Contracting Officer natalie.mitchell@fda.hhs.gov

By: July 26, 2016, 11:00 ET

This survey pertains to Contractor:

This survey is pertaining to the company named:

Department/Component:

Contract Number: Date of Survey: Name of Person Completing Survey:

Signature of Person Completing Survey: Your Company/Agency:

Your Role in this Contract(circle one):

Contracting Officer Contract Specialist Project Officer Other

Contract Value (including options): $

Performance Period:

(Including option periods)

Type of Contract:

Approximate percentage of work being performed (or completed) by subcontractor(s): % Information on subcontractor(s) (where more than 51% of work was completed by the subcontractor):

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

General description of products/services required under the contract:

RATINGS

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 shall be noted on page 4.

Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent), 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 contractor to make a determination on any of the performance criteria below, please circle "N/A" (not applicable/no opinion).

QUALITY OF SERVICE

1. Compliance with the requirement 0 1 2 3 4 5 N/A

2. Accuracy of reports 0 1 2 3 4 5 N/A

3. Effectiveness of personnel 0 1 2 3 4 5 N/A

4. Technical Excellence 0 1 2 3 4 5 N/A

COST CONTROL

1. Record of forecasting and controlling target costs 0 1 2 3 4 5 N/A

2. Current, accurate and complete billings 0 1 2 3 4 5 N/A

3. Relationship of negotiated costs to actuals 0 1 2 3 4 5 N/A

4. Cost efficiencies 0 1 2 3 4 5 N/A

TIMELINESS OF PERFORMANCE

1. Met interim milestones 0 1 2 3 4 5 N/A

2. Reliability 0 1 2 3 4 5 N/A

3. Responsive to technical direction 0 1 2 3 4 5 N/A

6. Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS

CUSTOMER SATISFACTION

1.

The contractor is committed to customer satisfaction.

Yes No (circle one)

2.

Would you recommend selection of this firm again?

Yes No (circle one)

ADDITIONAL COMMENTS:

[This space intentionally left blank]

RATING GUIDELINES

QUALITY OF PRODUCT OR SERVICE

COST CONTROL

TIMELINESS OF PERFORMANCE

BUSINESS RELATIONS

0-Unsatisfactory Contractor is not in compliance and is jeopardizing achievement of BPAobjectives Contractor is unable to manage costs effectively Contractor delays are jeopardizing performance of BPAobjectives Response to inquiries, technical/ service/ administrative issues is not effective 1-Poor Major problems have been encountered Contractor is having major difficulty managing costs effectively Contractor is having major difficulty meeting milestones and delivery schedule Response to inquiries, technical/ service/ administrative issues is marginally effective 2-Fair Some problems have been encountered Contractor is having some problems managing costs effectively Contractor is having some problems meeting milestones and delivery schedule Response to inquiries, technical/ service/ administrative issues is somewhat effective 3-Good Minor inefficiencies/ errors have been identified Contractor is usually effective in managing costs Contractor is usually effective in meeting milestones and delivery schedule Response to inquiries, technical/ service/ administrative issues is usually effective 4-Excellent Contractor is in compliance with BPArequirements and/or delivers quality products/services Contractor is effective in managing costs and submits current, accurate, and complete billings Contractor is effective in meeting milestones and delivery schedule Response to inquiries, technical/ service/ administrative issues is effective 5-Outstanding: The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as "Excellent."