Attachment 5 - Past Performance Rating Form.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- Personal Protective Equipment Federal contract opportunity
- Solicitation number
- 19AQMR24R0001
About this file
This document is a Past Performance Customer Satisfaction Survey for a federal contract opportunity. The survey was provided by the U.S. Department of State (DOS) to a customer reference who has worked with the prospective offeror XXXX on a previous contract.
The survey covers key performance areas including technical services, quality of services, timeliness of performance, price/cost control, business relations, and overall customer satisfaction. The customer is asked to provide ratings from "Excellent" to "Unacceptable" for various criteria within each performance area. The survey also requests the customer's recommendation on whether they would award another contract to the contractor.
The related federal contract opportunity is for the procurement of Personal Protective Equipment (PPE) to be donated to the Government of Mexico. The solicitation number is 19AQMR24R0001, and proposals are due to the Contracting Officer (diangelome@state.gov) by 10 a.m. on December 28th. Questions concerning the solicitation must be submitted to the Contracting Officer by 5 p.m. on December 8th.
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Text version
Customer Satisfaction Survey
| PAST PERFORMANCE CUSTOMER SATISFACTION SURVEY | |
| Introduction: The United States Department of State (DOS) is currently conducting a competitive procurement for personal protective equipment, for which the prospective offeror XXXX has been requested to identify Government agencies or commercial vendors with whom it is currently or has been recently under contract, to serve as potential references on its past performance record. You are being asked to complete this survey. You may also be contacted by a DOS procurement official to arrange a telephone interview, using the survey as the focal point of the interview. To ensure frank and open evaluations and expressions of opinions by evaluators, all parties are advised that the identity of respondents completing the survey will be held in confidence and will not be released or disclosed to the contractor or outside the Government. | |
| Instructions: Please complete all areas of this form indicated in light yellow. | |
| PART I - CONTRACT INFORMATION | |
| a. Contractor: | |
| b. Customer Name (Federal Agency or Other): | |
| c. Technical Point of Contact Information | |
| i. Name: | |
| ii. Telephone Number: | |
| iii. E-mail Address: | |
| iv. Position Title: | |
| d. Contract Number: | |
| e. Type of Contract | (Select responses from drop down menu) |
| i. Competitive or Non-Competitive: | |
| ii. Contract Type: | |
| f. Contract Period of Performance: | |
| g. Current (or Completed) Contract Value: $ | |
| h. Brief Description of the Contract Requirement: | |
| PART II - GOVERNMENT PAST PERFORMANCE/CUSTOMER SATISFACTION EVALUATION | |
| EVALUATION CRITERIA | |
| EXCELLENT: Indicates the Contractor's performance within the area of evaluation clearly and consistently exceeds contractual requirements. | |
| SATISFACTORY: Indicates the Contractor's performance within the area of evaluation met the contractual requirements. If problems were identified, they were only minor in nature and solutions were provided. | |
| MARGINAL: Indicates the area of evaluation contains or contained a problem for which there is doubt whether the identified solution is adequate but the problem appears to be within the contractor's ability to solve. | |
| UNACCEPTABLE: Indicates the Contractor's performance within the area of evaluation experienced serious problems. The Contractor is/was in danger of being unable to satisfy contractual requirements and timely recovery is not likely or did not occur. |
| NOT APPLICABLE: Performance did not include such efforts or performance was not observed. | |
| EVALUATION AREA 1: TECHNICAL SERVICES | |
| (Select the rating that applies from drop down menu) | |
| Overall ability to provide all necessary resources including personnel, management, supplies, services, materials, equipment, facilities, and transportation necessary to provdie a wide range of forensics and non-intrusive inspection equipment and support. | |
| Overall ability to integrate and manage team partners and stake holders (domestic and overseas) to ensure successful mission performance | |
| Overall ability to adapt to local conditions where work is to be performed | |
| Overall ability to coordinate and integrate work to prevent unnecessary duplication of services and minimize disruptions to contract timelines | |
| EVALUATION AREA 2: QUALITY OF SERVICES | |
| (Select the rating that applies from drop down menu) | |
| Overall ability to proactively and aggressively perform contract requirements: | |
| Effectiveness and reliability of contractor's key personnel: | |
| EVALUATION AREA 3: TIMELINESS OF PERFORMANCE | |
| (Select the rating that applies from drop down menu) | |
| Overall performance in planning, scheduling, and monitoring: | |
| Completion of major milestones on schedule: | |
| Timely completion of efforts within period of performance: | |
| EVALUATION AREA 4: PRICE/COST CONTROL | |
| (Select the rating that applies from drop down menu) | |
| Quality, completeness, and accuracy of price/cost proposals/invoices: | |
| Accuracy and timeliness of cost reports: | |
| Ability to perform within negotiated costs/prices: | |
| Ability to provide innovative solutions that resulted in cost savings: | |
| EVALUATION AREA 5: BUSINESS RELATIONS | |
| (Select the rating that applies from drop down menu) | |
| Ability to effectively manage contract: | |
| Ability to work in collaboration with other contractors towards a common goal: | |
| Ability to choose and manage quality subcontractors: | |
| EVALUATION AREA 6: CUSTOMER SATISFACTION | |
| (Select the rating that applies from drop down menu) | |
| Maintains a single effective point of contact to manage and resolve problems: | |
| Effectiveness in interfacing with personnel in your organization: | |
| Overall ability to resolve performance issues: | |
| EVALUATION AREA 7: OVERALL CONTRACT PERFORMANCE | |
| (Select the rating that applies from drop down menu) | |
| Based on this contractor's overall performance, would you award this contractor another contract? | |
| COMMENTS (Please include any additional comments concerning the past performance of the contractor): |
Thank you for completing this survey. Please provide your responses to the Contracting Officer, Mary DiAngelo, at diangelome@state.gov
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