26QE011_ATTCH8_PPQ.docx

SOLICITATION Number:HE125426QE011 DoDEA gRADES 6-12 SUICIDE PREVENTION INSTRUCTIONAL RESOURCES Present and Past Performance ATTACHMENT 08 Questionnaire

PRESENT AND PAST PERFORMANCE QUESTIONNAIRE

1. Please complete the following questionnaire and return via email to the attention of:

Department of Defense Education Activity

Contract Specialist: Eric Mensah Contract Specialist e-mail: Eric.mensah@dodea.edu and Contracting Officer: Jamie Formosa Contracting Officer e-mail: jamie.formosa@dodea.edu

2. This Questionnaire Pertains to:

(Prime) Vendor Name

Reference Information Table (Table to be filled out by the Prime Vendor prior to fowarding to reference) Business Name of Reference & Address

Name Point of Contact

POC Phone number

POC E-mail address

Contract Value

Contract Number

Contract Type

Period of Performance

Brief Description of Effort/Scope of Work

3. Reference Section Part I:

Please refer to the Scope Verification above in Section 2. Is this description of the scope of work correct? If not, please amend it.

Have you encountered any significant problems with the company’s resources and/or support services? If so, please explain.

4. Reference Section Part II:

Evaluation KEY: Please use the following abbreviations to assign an applicable rating for questions 1 thru 4 below:

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

Directions: Double-click the box in the table to select a rating. Choose “checked” as “default value” to select the rating for each question.

1. How would you rate the vendor’s compliance with the delivery of contract deliverables or contract requirements?

Comments:

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

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

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

3. How would you rate the vendor’s record of conforming to contract requirements and to standards of good quality of their resources and services provided?

4. How would you rate the vendor’s overall performance?

5. Would you purchase services from this vendor again?

|_| YES |_|NO

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

Thank you for taking the time to complete this past performance questionnaire.

Procurement Sensitive Source Selection Information-See FAR 3.104- Controlled Unclassified Information