Attachment_III_-_Past_Performance_Evaluation_Document.docx

1645DC-18-R-00002

Attachment II: Past Performance Evaluation Document

1645DC-18-P-00002

PAST PERFORMANCE EVALUATION DOCUMENT

REQUEST FOR PROPOSAL #: 1645DC-18-R-00002

All evaluations are due via email to the Contracting Specialist at tek.ozge@dol.gov no later than FRIDAY, 20 APRIL 2018, 5:00PM ET

Absolutely no late evaluations will be accepted, no exceptions.

TO: Government agency or commercial organization (i.e., customer) with knowledge on offeror’s past performance.

Please complete this evaluation, which concerns the past performance of a contractor or subcontractor who is doing business (or has done business) with you, and is interested in doing business with the Mine Safety and Health Administration (MSHA). Handwritten responses are acceptable; however, typed responses are preferred. The contractor who provided MSHA with your name as a reference was informed, via a solicitation provision, that by listing you as a reference and requesting your submission of the evaluation, they are authorizing you to release information to MSHA relative to their past performance, whether it is positive or negative information. Please fill out the attached evaluation and return directly to the Contract Specialist via email to tek.ozge@dol.gov. MSHA may contact you to clarify or verify any information provided. Please be sure to sign the document before returning to the Contract Specialist.

CERTIFICATION

By law, the Government will not disclose the names of individuals providing reference information during discussions with the contractor identified in Block 1 below.

Block 1. Contractor Name:

Block 2. Contract Number and Project Name:

I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS QUESTIONNAIRE IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Evaluator’s Printed Name

Title/Role (e.g. Program Manager, Contracting Officer)

Evaluator’s Mailing Address (Agency, Bldg/Rm, Street, City, State, Zip)

Evaluator’s Signature Date Phone Fax

INSTRUCTIONS

Two forms are provided to document your opinion: 1) Performance Rating Form; and 2) Supplemental Comment Form. Please fill out each form in accordance with the instructions provided on each. Please use the following standards in arriving at your rating:

Acceptable - Contractor, on balance, met customer expectations and requirements. The Evaluation Factor response is expected to introduce some risk in achieving the objectives. An ACCEPTABLE rating indicates that strengths offset weaknesses. Performance meets contractual requirements. The contractual performance of the element being assessed contains some minor problems for which correction actions taken by the contractor appear or were satisfactory.

Unacceptable - Contractor, on balance, was either marginal or did not meet customer expectations and requirements. The Evaluation Factor response is expected to introduce excessive risk making it highly unlikely that performance would meet the objectives. An UNACCEPTABLE rating indicates that the submission contains significant weaknesses and few, if any, strengths. Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Neutral - The element is not applicable, no data has been obtained, or additional comments are provided. No relevant past performance available for evaluation. Unable to provide a score. Performance in this area not applicable to effort assessed.

Please mark the column to the right of each element that most appropriately reflects your experience with this contractor.

PERFORMANCE RATING FORM

1. QUALITY OF SOLUTION: The contractor comprehended the goals, thoroughly researched the problem, and presented a comprehensive, complete, feasible, and effective solution. (Met the needs and performed successfully).

2. EFFECTIVE AND EFFICIENT USE OF RESOURCES: The Contractor deployed, in a timely manner, the proper amount and type of personnel, facilities, and other resources to support the project. Use of subcontractors was appropriate in supporting the project.

3. COMMUNICATION: The contractor worked and communicated well with client management, staff, and contracting officials as well as with his or her own staff and subcontractors.

4. TIMELINESS OF PERFORMANCE: The contractor planned and proposed realistic schedules, successfully monitored performance and completed work on time.

5. CUSTOMER SATISFACTION: The contractor exhibited a commitment to customer satisfaction and achieved customer satisfaction.

6. RESPONSIVENESS AND ATTENTIVENESS: The contractor exhibited reasonable and cooperative behavior in response to client changes, criticism/rejection of contract deliverables and in detecting and correcting errors, poor performance, and other problems.

7. COST CONTROL: The contractor successfully planned and proposed realistic costs and monitored performance, and consistently operated at or below budget.

8. Given the choice would you do business with this contractor again?

9. Did either you or the contractor have to resort to litigation to resolve problems?

SUPPLEMENTAL COMMENT FORM

If the contractor was rated “Unacceptable” for any category, please provide additional comments regarding this rating in the appropriate spaces below. Please add additional pages as necessary.

Performance Element #1, Quality of Solution:

Performance Element #2, Effective and Efficient Use of Resources:

Performance Element #3, Communication:

Performance Element #4, Timeliness of Performance:

Performance Element #5, Customer Satisfaction:

Performance Element #6, Responsiveness and Attentiveness:

Performance Element #7, Cost Control:

Question #8, Given the choice would you do business with this contractor again?:

Question #9, Did either you or the contractor have to resort to litigation to resolve problems?

Additional Comments: