J.7 - Past Performance Survey.doc

Attachment 7

Past Performance Survey

Please fax completed surveys to:

Centers for Disease Control and Prevention (CDC)

Procurement and Grants Office ATTN: Mac Mutter 2920 Brandywine Road, Mailstop K-75

Atlanta, Georgia 30341

Phone: (770) 488-2638 Fax: (770) 488-2688 The below contractor has submitted a proposal to provide various technical and operational activities in response to a recent solicitation. This contractor has identified your contract listed below as containing like or similar services as required under our solicitation. Please complete this Past Performance Survey and fax it to the above POC by the proposal due date in the solicitation.

Contractor Information:

a. Contractor Name:___________________________________________________________________________

b. Program Name:____________________________________________________________________________

c. Contract Number: __________________________________________________________________________

d. Contract Type: _____________________________________________________________________________

e. Contract amount:____________________________________________________________________________

f. Period of performance:________________________________________________________________________

g. Description and Location of work:

TO BE COMPLETED BY REFERENCE

a. Name of person completing this questionnaire:

b. Signature of person completing this questionnaire:

c. Your role with respect to the contractor (e.g., Contracting Officer/Contract Manager, COR/COTR, Program Manager, etc.):

d. Agency/company:

e. Telephone with area code:

f. Fax number with area code:

g. Date questionnaire completed:

Objective Measurable Performance Iindicators Excellent:

Performance consistently exceeded contract requirements, customer expectations, and provided significant, unique or worthwhile features or benefits.

Good:

Performance consistently met, and occasionally exceeded, contract requirements and customer expectations. Demonstrated an understanding of the requirements, provided an acceptable management and technical approach, and provided complete responses to customer needs.

Satisfactory:

Met the performance level of the contract.

Marginal:

Usually met the contract performance level, however at a marginal level. Performance could have been improved and occasionally fell short of customer expectations.

Poor:

Performance did not meet customer expectations and/or contract requirements.

Please answer each of the following questions with a rating based on the objective measurable performance indicators listed above. Commentary to explain any rating can be noted in the margins or on an attachment.

1. Evaluate the contractor’s labor force in terms of overall qualifications to perform the work required.

Excellent Good Satisfactory Marginal Poor

2. Evaluate the stability of the contractor’s work force as affected by employee turnover and contract vacancies.

Excellent Good Satisfactory Marginal Poor

3. Evaluate how well the contractor conducted work in a smooth and responsive manner during the initial start up or transition period. Please indicate whether the work was transitioned from Government responsibility or another contractor’s responsibility.

Excellent Good Satisfactory Marginal Poor

Previous Contractor Responsibility Previous Government Responsibility

4. Evaluate the contractor’s adherence to task schedules and mission requirements.

Excellent Good Satisfactory Marginal Poor

5. Evaluate the contractor’s ability to provide world-wide technical assistance and support and capacity building for global HIV/AIDS activities and programs.

Excellent Good Satisfactory Marginal Poor

6. Evaluate the contractor’s responsiveness to technical direction.

Excellent Good Satisfactory Marginal Poor

7. Evaluate the responsiveness and quality of the contractor’s reports and documentation.

Excellent Good Satisfactory Marginal Poor

8. Evaluate the contractor’s ability to solve business management problems without extensive guidance from the procuring agency.

Excellent Good Satisfactory Marginal Poor

9. Evaluate the contractor’s ability to overcome program, technical, or schedule difficulties without extensive guidance from the procuring agency.

Excellent Good Satisfactory Marginal Poor

10. Evaluate the contractor’s willingness and ability to integrate as a team and work cooperatively with the existing work force (Government and/or other contractors).

Excellent Good Satisfactory Marginal Poor

11. Evaluate the contractor’s cost reporting and estimating system.

Excellent Good Satisfactory Marginal Poor

12. Evaluate the contractor’s overall performance.

Excellent Good Satisfactory Marginal Poor

13. Would you be willing to have this contractor do additional work for your Orginazition in the future?

Yes_____ No______

Other Informational Comments:

Pro:

Con: