Attachment_J2_Questionnaires.docx

ATTACHMENT J2

RFP 2016-N-17825

PAST/PRESENT PERFORMANCE REFERENCE QUESTIONNAIRE INSTRUCTIONS

Instructions: OFFEROR shall complete the PAST/PRESENT PERFORMANCE REFERENCE QUESTIONNAIRE Reference Information Table themselves for the attached questionnaire, identifying the name and other pertinent information for each of your three (3) selected business references. This table, including the name of the offeror, shall be filled out completely by the offeror BEFORE sending it to the customers to respond to the questions. This will ensure the accuracy of the information being provided.

Send the attached questionnaire to each of the customers with a cover letter that:

(a) authorizes the selected customers to discuss the offeror’s performance under the applicable contract with the contracting officer;

(b) requests the customer complete the questionnaire;

(a) instructs the customer to return the completed questionnaire to the Contracting Officer:

Ms. Sherrie Randall, by email: MAPSS@CDC.GOV

Submit a copy of the customer’s cover letter with your business proposal to ensure receipt of questionnaire responses.

PAST/PRESENT PERFORMANCE REFERENCE QUESTIONNAIRE

RFP 2016-N-17825

Name of Offeror:

Reference Information Table

Poor/ Unsatisfactory

Does not meet minimum acceptable standards in one or more areas; remedial action required in one or more areas; deficiencies in one or more areas which adversely affect overall performance.

Meets or slightly exceeds minimum acceptable standards; adequate results; reportable deficiencies with identifiable, but not substantial, effects on overall performance.

Effective performance; fully responsive to contract requirements; reportable deficiencies, but with little identifiable effect on overall performance.

Very effective performance; fully responsive to contract requirements; contract requirements accomplished in a timely, efficient, and economical manner for the most part; only minor deficiencies with minimal effect on overall performance.

Of exceptional merit; exemplary performance in a timely, efficient, and economical manner; very minor (if any) deficiencies with no adverse effect on overall performance.

No record of relevant past performance or past performance information is not available

1. How would you rate the contractor’s compliance with the delivery schedule / performance milestones?

Comments:

P/U|_| S|_| G|_| VG|_| E|_| N|_|

2. How would you rate the contractor’s business practices (e.g. maintaining a positive working relationship, business ethics, timely and effectively resolution of any problems etc.)?

3. How would you rate the contractor’s record of conforming to contract requirements and to standards of good workmanship/quality of the product or service?

4. How would you rate the contractor’s overall compliance with the terms and conditions of your purchase order /contract?

5. How would you rate the contractor’s history of reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business-like concern for the interest of the customer?

6. How would you rate the contractor’s overall performance?

7. Would you purchase services from this contractor again?

|_| YES |_|NO

Please provide any additional comments applicable to the contractor’s past performance:

EVALUATOR’S NAME (Signature): ___________________________________________

TITLE OF EVALUATOR:___________________________________________

PHONE NUMBER:________________________________________________

EMAIL ADDRESS:_______________________________________________

DATE: _________________