Attachment_G.docx

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Medical Examination Services
Solicitation number
60RRBH18R0015
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Attachment G

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60RRBH18R0015_Amendment_0001_with_Attachment_H_(Q+A).pdf PDF
Exhibit_1.docx DOCX document
60RRBH18R0015.pdf PDF
Attachment_B.docx DOCX document
Exhibit_2.docx DOCX document
Attachment_F.doc DOC document
Attachment_D.pdf PDF
Attachment_A.docx DOCX document
Attachment_C.docx DOCX document
Exhibit_3.docx DOCX document
Exhibit_4.pdf PDF
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PAST PERFORMANCE QUESTIONNAIRE

Name of Evaluator: ________________________________

Official Position: ________________________________

Name of Company: ________________________________

Company Address: ________________________________

Phone/Fax/Email: ________________________________

Period of Performance: ________________________________

Contract No. (Indicate
prime/subcontractor):________________________________

Contract Type: ________________________________

Contract Value: ________________________________

Please provide a thorough and complete description of the most recent services you have contracted for from the vendor.

Solicitation No. 60RRBH18R0015 Page 1 of 4 Attachment G – Past Performance Questionnaire

INSTRUCTIONS – For each item, circle the rating that best describes the contractor’s work on this project and provide any additional comments. For items not applicable to your project, please indicate N/A.

5= ExcellentNo problems, issues, or delays in achieving contract requirements
4= GoodDoes not impact achievement of contract requirements
3=SatisfactoryRequires minor agency resources to ensure achievement of contract requirements
2=MarginalRequires major agency resources to ensure achievement of contract requirements
1= UnsatisfactoryAchievement of contract requirement is compromised
N/A= Not applicableDoes not apply

(1) Overall implementation of the contract 5 4 3 2 1 N/A

Comments:

(2) Ability to pro-actively and aggressively perform 5 4 3 2 1 N/A contract requirements(s)

(3) Effectiveness and reliability of contractor's key personnel 5 4 3 2 1 N/A

(4) Quality and quantity of the training materials provided 5 4 3 2 1 N/A by the contractor

(5) Quality of the contractor’s on-going technical 5 4 3 2 1 N/A assistance and customer service

(6) Quality of the contractor’s reporting features and tools 5 4 3 2 1 N/A

(7) Overall ability to effectively manage contract 5 4 3 2 1 N/A

(8) Overall performance in planning, scheduling, and monitoring 5 4 3 2 1 N/A contract requirements

(9) Timely completion of major milestones 5 4 3 2 1 N/A

(10) Responsiveness/capability to respond to surge/short term 5 4 3 2 1 N/A requirements and aggressive timelines

(11) Displays initiative in meeting Government requirements 5 4 3 2 1 N/A and is responsive to the Government's needs

(12) Responsiveness and flexibility in responding to changes 5 4 3 2 1 N/A (both formal and informal)

(13) Provides prompt notification of problems 5 4 3 2 1 N/A

(14) Effectively assesses impacts of potential changes on other 5 4 3 2 1 N/A associated projects, tasks, and efforts

(15) Ability to solve contract performance problems without 5 4 3 2 1 N/A extensive guidance from Government personnel

(16) Overall management communication with your agency 5 4 3 2 1 N/A or organization

(17) Effectiveness in interfacing with Government personnel 5 4 3 2 1 N/A

(18) Quality of the contractor’s billing procedures, 5 4 3 2 1 N/A billing accuracy and resolution of billing discrepancies

(19) Ability to meet Agency’s security requirements 5 4 3 2 1 N/A

(20) For Federal responders, rate the ability of the contractor’s 5 4 3 2 1 N/A products to meet 508 regulatory and compliance guidelines

Comments:

Based on this contractor’s overall performance, would you award this contractor a similar contract?

Yes [ ]No [ ] If “no’, please explain:

Has this contract been partially or completely terminated?

Yes [ ] No [ ] If “yes’, please explain:

Were there any changes in contract dollar value throughout the life of the contract?

Yes [ ] No [ ] If “yes”, please explain:

In summary, please give your overall assessment of this contractor and the actual results achieved as a result of this contractor’s performance.

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