Attachment_E_-_Past_Performance_Questionnaire.docx

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Attached to
SURFACE TENSIOMETERS Federal contract opportunity
Solicitation number
2031ZA17R00007
Issued by
Department of the Treasury Bureau of Engraving and Printing

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Attachment E - Past Performance Questionnaire

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RFP-2031ZA17R00007 Past Performance Questionnaire Template

PAST PERFORMANCE QUESTIONNAIRE

Instructions:

· Sections I through III shall be completed by the Offeror/Major Subcontractor and provide the questionnaire to three Assessors (personnel or organization who have at least five (5) years of production experience using the Intaglio currency press from supplier) The Assessor, in turn, shall verify information in Sections I through III and complete Sections V through VII. The Assessors shall provide the completed questionnaire to the contracting office point of contact no later than the date and time indicated below. The Offeror shall submit with its proposal (by the closing date of the Solicitation) copies of Sections I and II of all questionnaires as provided to Assessors.

· Section II to be validated by the assessor. If any information is incorrect herein, please annotate and provide the correct information accordingly.

· Sections III through VII to be completed in their entirety by the assessor.

Message to the assessor: Your assistance is requested by the BEP to assist with establishing the performance history for the Contractor named below. In efforts to expedite receipt of the requested information, the Contracting Office respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to: Milagros.Cortes@bep.gov no later than 12:00 PM EASTERN TIME, Thursday, 10 August 2017.

I. Solicitation Data (for the proposed effort)

Solicitation Number
Request for Proposal No. RFP-2031ZA17R00007
Project/Requirement
SURFACE TENSIOMETERS Systems for the Bureau of Engraving and Printing (BEP) Eastern Washington D.C. Facility (DCF) and Western Currency Facilities (WCF) in Fort Worth, TX.

II. Current or Historical Contract Information Assessor: The performance data submitted by the Offeror is |_| correct or |_| incorrect.

CONTRACTOR NAME & ADDRESS:

Contract No

Type of Contract

Initial
Final

Contract Value

Period of Performance/Delivery Schedule

Project/Requirement Description

Please select from the following as it applies to this contract:

Contracting Role
|_| PRIME
|_| SUBCONTRACTOR
Termination History
|_| Convenience
|_| Default
|_| N/A

III. Assessor information for Integrated Packaging System only

Assessor Name

Title

Phone Number/Email Address

Identify your role in the contract award or administration and the period of your involvement.

Role
Period of Involvement

Procuring Contracting Officer (PCO)

Administrative Contracting Officer (ACO)

Contract Specialist

Contracting Officer’s Representative (COR)

Technical Project Lead/Project Manager

Quality Assurance Specialist

Defense Contract Audit Agency (DCAA) Auditor

Other:

IV. Evaluation Definitions

The following definitions should be used in your assessment of Contractor performance.

EXCEPTIONAL
Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.
VERY GOOD
Performance EXCEEDS SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.
SATISFACTORY
Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.
MARGINAL
Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.
UNSATISFACTORY
Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.
NOT APPLICABLE (N/A)
Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

V. Performance Evaluation

Exceptional
Very Good
Satisfactory
Marginal
Unacceptable
N/A

CUSTOMER SATISFACTION

The referenced contractor was responsive to the customer’s needs.

The contractor’s personnel were qualified to meet the requirements.

SCHEDULE PERFORMANCE

The contractor’s ability to ensure, to the extent of its responsibility, that all tasks were completed within the requested time frame.

Time required for the vendor to install, startup, commission and train your staff on the equipment to begin full production.

Timeliness in Meeting Milestones and deliverables (if applicable)

MANAGEMENT PERFORMANCE/PROGRAM MANAGEMENT

The contractor had a clear understanding of the tasks detailed in the Statement of Work

The contractor’s ability to complete tasks correctly the first time.

The contractor’s ability to resolve problems.

Did the contractor successfully manage its subcontractors?

Was the contractor’s management effective in controlling cost, schedule and performance requirements?

QUALITY

What is your OVERALL assessment of the quality of the contractor’s performance? Were your specifications and expectations met by the contractor?

Quality of the finished product; please note any specific issues.

Conformance to Contract Requirements

Standards of Good Workmanship (technical, professional, environmental, safety, etc.)

COST

The contractor’s ability to accurately estimate cost.

COST/PRICE ESTIMATES—(ability to meet proposed costs and whether actual costs/rates realized reflect negotiated costs/rates)

INVOICING—accuracy and timeliness of submission

General Comments:

_____________________________________________________
Assessor’s SignatureDate

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