past perf -fixed price.doc

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Audiometric Test Frequency Federal contract opportunity
Solicitation number
2009-N-11203
Issued by
Department of Health and Human Services Centers for Disease Control and Prevention Cincinatti

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CONTRACTOR PERFORMANCE REPORT – FIXED PRICE

[ ] Final [ ] Interim - Period Report: From To ___ _____

1. Contractor Name and Address:

2. Contract Number: __________________

3. Contract Value (Base Plus Option): $

4. Contract Award Date:

Contract Completion Date:

5.

Type of Contract: (AX@ all that apply) [ ] FP [ ] FP-EPA [ ] Requirements [ ] Labor Hour [ ] T&M [ ] SBSA 8(a) [ ] SBIR [ ] Sealed Bid [ ] Negotiated [ ] Competitive [ ] Non-Competitive [ ]Other (Specify)

6. Description of Requirement:

7. Ratings. Summarize contractor performance and place an AX@ in the applicable bracket for the number which corresponds to the performance rating for each category. Please see page three for explanation of rating scale.

QUALITY OF PRODUCT OR SERVICE

Comments:

0 [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5+[ ]

VALUE

Comments:

0 [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5+[ ]

TIMELINESS OF PERFORMANCE

Comments:

0 [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5+[ ]

BUSINESS RELATIONS

Comments:

0 [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5+[ ]

TOTAL

MEAN SCORE (Divide the total rating above by the number of areas rated):

8. KEY PERSONNEL

Project Manager:

Name:

Comments/Rating:

Name:

Comments/Rating:

Name:

Comments/Rating:

Employment Dates:

Comments/Rating (cont) Employment Dates:

Comments/Rating (cont) Employment Dates:

Comments/Rating (cont)

9. Would you select this firm again? Please explain.

10. Project Officer Name: ______________________ Signature: _________________________________ Date: ___________________________

11. CONTRACTORS REVIEW: Were comments, rebuttals, or additional information provided? [ ] No [ ] Yes. Please attach comments.

12. Contractor Name: Signature: __________________________________ Phone:

Fax: Date: __________________________ Internet address: ________________________________

13. AGENCY REVIEW: Were contractor comments reviewed at a level above the contracting officer? [ ] No [ ] Yes. Comments attached.

14. FINAL RATINGS: Re-assess the Block 7 ratings based on contractor comments and agency review. Validate or revise as appropriate.

Quality Value Timeliness Business Relations

Mean Score (Add the ratings above and divide by number of areas rated):

15. Contracting Officer=s Name: Signature: ____________________________ Phone: ________________________________ Fax: Date: ________________________________ Internet address: ______________________________

RATING GUIDELINES

Summarize contractor performance in each of the rating areas. Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent), or 5 (Plus). Us the following instructions as guidance in making these evaluations.

Quality of Product/Service -Compliance with contract requirements -Accuracy of reports -Appropriateness of personnel -Technical excellence

Value -Current, accurate, and complete billings -Complaints concerning subcontractor and employee payments -Labor complaints -Price versus value (quality)

Timeliness -Net interim milestones -Reliable -Responsive to technical direction -Completed on time, including wrap-up and contract administration -No liquidated damages assessed

Business Relations -Effective Management -Businesslike correspon- dence -Responsive to contract requirements -Prompt notification of problems -Reasonable/cooperative -Flexible -Pro-active -Effective contractor recommended solutions -Effective small/small disadvantaged business subcontracting program

0. Unsatisfactory Nonconformances are compromising achievement of contract requirements despite use of Agency resources

Value issues are compromising performance of contract requirements

Delays are compromising the achievement of contract requirements, despite use of Agency resources.

Response to inquiries technical/ service/admin issues are not effective and responsive

1. Poor Nonconformances require major Agency resources to ensure achievement of contract requirements

Value issues require major Agency resources to ensure achievement of contract requirements

Delays require major Agency resources to ensure achievement of contract requirements

Response to inquiries technical/ service/admin issues are marginally effective and responsive

2. Fair Nonconformances require minor Agency resources to ensure achievement of contract requirements

Value issues require minor Agency resources to ensure achievement of contract requirements

Delays do not impact achievement of contract requirements

Response to inquiries technical /service/admin issues are usually effective and responsive

3. Good Nonconformances do not impact achievement of contract requirements

Value issues do not impact achievement of contract requirements

Delays do not impact achievement of contract requirements

Response to inquiries technical/ service/admin issues are usually effective and responsive

4. Excellent There are no quality problems

There are no value issues

There are no delays

Response to inquiries technical/service/admin issues are effective and responsive

5. PLUS - The contractor has demonstrated an exceptional 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 AExcellent@.

CONTRACTOR PERFORMANCE REPORT INSTRUCTIONS

Block 1:

Contractor Name and Address. Identify the specific division being evaluated if there is more than one.

Block 2:

Contract number of contract being evaluated.

Block 3:

Contract value shall include base plus options. If funding was increased or decreased during the instant evaluation period, the value in this block should reflect the change.

Block 4:

Contract award date and anticipated or anticipated contract completion date.

Block 5:

Type of contract: Check all that apply.

Block 6:

Provide a brief description of the work and identify the key performance indicators. This description will allow agencies calling for reference checks to compare specifications.

Block 7:

Pleace an AX@ in applicable bracket. Provide brief narrative for each category rated. Indicate contract requirements that exceeded minimum requirement, or those requirements that were not met and extent. Calculate the mean score rating.

Block 8:

List the names and employment dates of the contractor=s key personnel. Attach an additional page if necessary. On the comment/rating line briefly describe the managers performance.

Block 9:

Provide and explanation for selecting this offeror for future acquisitions.

Block 10:

The program office person most familiar with the contractor=s performance should sign this block. The rating is a combined program office, contracting officer decision. The contracting officers signature in block 15, signifies concurrence with this rating and the final rating, if a revised rating is necessary.

Blocks 11-12:

The contractor may provide comments but must sign block 12 to indicate review of the rating.

Block 13:

If the contractor and contracting officer are unable to agree on a final rating, an agency review at a level above the contracting officer is required.

Block 14:

Adjust the ratings assigned in block 7, if appropriate, based on any comments, rebuttals, or additional information provided by the contractor and, if necessary, bu the agency review. Calculate a mean score of the contractor=s performance.

Block 15:

The contracting officer=s signature certifies concurrence with the initial and final ratings.

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