Attachment_B_PPQ_Sol.__60RRBH20R0002.docx
DOCX document 19 KB Posted
- Solicitation number
- 60RRBH20R0002
- Issued by
-
Railroad Retirement Board
About this file
Attachment B Past Performance Questionnaire
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| File | Type | Posted |
|---|---|---|
| 60RRBH20R0002_Quality_Assesment_Review_Initial_Disability_Determination.pdf | ||
| Attachment_A_-_Medical_Contractor_Review_Questions_10-21-19.docx | DOCX document |
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Text version
Solicitation No. 60RRBH20R0002 Page 1 of 3 Attachment B
Annual Quality Review of Initial Disability Determination
PROGRAM EVALUATION AND MANAGEMENT SERVICES
RAILROAD RETIREMENT BOARD
PERFORMANCE EVALUATION FORM & PAST PERFORMANCE QUESTIONNAIRE
Name of Evaluator:
Official Position:
Name of Company:
Company Address:
Phone/Fax/Email:
Name of Contractor:
Period of Performance:
Contract No. or Reference’s Name:
Contract Type:
Contract Value:
Please provide a thorough and complete description of the most recent services you have contracted for from the vendor.
Print Name: _________________________________________________
Signature: __________________________________________________ Date: ____________________
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 = Excellent |
| No problems, issues, or delays in achieving contract requirements |
| 4 = Good |
| Does not impact achievement of contract requirements |
| 3 = Satisfactory |
| Requires minor agency resources to ensure achievement of contract requirements |
| 2 = Marginal |
| Requires major agency resources to ensure achievement of contract requirements |
| 1 = Unsatisfactory |
| Achievement of contract requirement is compromised |
| For Yes or No Questions |
| 5 = YES; 1 = NO |
| N/A = Not Applicable |
| Does not apply |
| 1. Overall implementation of the contract? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 2. Ability to pro-actively and aggressively perform contract requirements and quality of service? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 3. Effectiveness and reliability of contractor’s key personnel? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 4. Timeliness of performance, reliability, and ability to meet contractually established deadlines? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 5. Customer satisfaction; was the contractor’s staff responsive, cooperative, and effective in working with your staff, and were there an adequate number of staff resources? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 6. Effectiveness in interfacing with agency or organization personnel? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 7. Overall business relations with your agency or organization, and the contractor’s ability to effectively respond to inquiries? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 8. Quality of the contractor’s billing procedures, billing accuracy and resolution of billing discrepancies? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 9. Ability to meet agency’s or organization’s security requirements? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 10. Contractor’s overall technical competence? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
| 11. Based on this contractor’s overall performance, would you award this contractor a similar contract? |
| 5 |
| 4 |
| 3 |
| 2 |
| 1 |
| N/A |
Comments:
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