2.2.1 Att 8 - Past Performance Questionnaire - DR-4559-4570-LA.docx

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Attached to
FEMA Maintenance and Deactivation of TTHUs (DR-4559/4570-LA)
Solicitation number
70FBR624R00000002
Issued by

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This document contains a past performance questionnaire for a contractor responding to Federal Emergency Management Agency solicitation number 70FBR624R00000002 for maintenance and deactivation of transportable temporary housing units in support of disaster relief efforts in Louisiana. The contractor is asked to provide information on relevant prior contracts, including agency and location, contract type and value, period of performance, and subcontracting details. The client completing the questionnaire is asked to evaluate the contractor's performance on factors such as quality, cost control, timeliness, business relations, and management using a rating scale of outstanding, good, acceptable, unsatisfactory, or neutral. The client is also asked if they would award the contractor another contract and for any additional remarks on the contractor's solution and performance.

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(Offeror to complete Part I prior to providing this questionnaire to the Evaluator.)

In order to assess potential vendors under the above-referenced solicitation, 70FBR624R00000002 the DHS/FEMA Contracting Office is obtaining past performance information with respect to each offeror. The contract resulting from this procurement will provide DHS/FEMA with Maintenance and Deactivation of Transportable Temporary Housing Units (TTHUs) in support of disaster DR-4559 and 4570 in Louisiana. In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is a critical acquisition being conducted by DHS/FEMA and your support is sincerely appreciated. We are thanking you in advance for your time, effort, and cooperation in responding to this questionnaire.

CLIENT/EVALUATION SHALL RETURN THIS QUESTIONNAIRE VIA EMAIL TO DIRECTLY TO THE FOLLOWING CONTRACTNG OFFICER jules.shabazz@fema.dhs.gov

<insert your company name above>

If you need more space than provided, attach additional pages. Responses will be treated as source selection sensitive information. If you have any questions, please contact the Contracting Officers at the e-mail address indicated above.

PART I – TO BE COMPLETED BY OFFEROR AND TRANSMITTED TO CLIENT FOR COMPLETION.

A. CONTRACT INFORMATION:

NAME OF

CONTRACTOR/OFFEROR:

1
Agency Name/Location:
2
Program/Project Title:
3
Type of Instrument (e.g.

Contract/Order/Subcontract/Other):

4
Contract Identification Number:
5
Order Number (If applicable):

Attachment 8 - Past Performance Questionnaire Solicitation: 70FBR624R00000002

70FBR624Q00000001

70FBR624Q00000001

DHS/FEMA

6
Project Service Description (Add attachment if necessary):
7
Type of Contract (e.g.

Negotiated, Sealed Bid):

8
Pricing Type (e.g. fixed price,

cost reimbursement, other):

9
Competitive (Y/N):
10
Follow-on Work Available

(Y/N):

Follow-on Work Awarded to Offeror (Y/N):

11
Date of Award:
12
Initial Contract Dollar Value

(w/Options):

13
Final Contract Dollar Value

(w/Options):

14
Period of Performance:
15
Place(s) of Performance:
15
Complexity of Work (e.g.

difficult, routine, simple):

16
Type and extent of subcontracting (add rows if needed):

Attachment 8 - Past Performance Questionnaire Solicitation: 70FBR624R00000002

PART II – TO BE COMPLETED BY OFFEROR’S CLIENT AND E-MAILED TO CONTRACTING OFFICERS

A. REFERENCE RESPONDENT INFORMATION

1
Name (please print):
2
Agency / Company:
3
Position Title:
4
Phone Number (include area

code):

5
Fax Number (include area code):
6
Email Address:
7
Mailing Address:
8
Your Role Relative to the Project/ Contract (e.g., COTR, PM):
9
Length of Involvement in Project/Contract:
10
Questionnaire Completion Date:

``Attachment 8 - Past Performance Questionnaire Solicitation: 70FBR624R00000002

B. PERFORMANCE ASSESSMENT

Please rate the contractor’s performance on the identified program using the following rating scale. Assessments should reflect only contract performance for which the contractor is responsible.

Rating
Symbol
Definition

Outstanding

O Based on the Offeror’s record of past performance, no issues, concerns, or risks are associated with receiving timely services and contract performance. Past performance surveys and the Offeror’s experiences indicate that the Offeror is capable of significantly exceeding the requirements of the RFP.

Good

G The Offeror’s record of past performance indicates there is very little risk associated with receiving quality products, timely services and full contract performance. Past performance surveys and the Offeror’s experience indicate the Offeror is capable of exceeding the requirements of the RFP.

Acceptable

A The Offer’s record of past performance indicates that there is some potential risk associated with receiving quality products, timely services, and contract performance. Past performance surveys and the Offeror’s experience indicate the Offeror is capable of meeting the requirements of the RFP.

Unsatisfactory
U
The Offeror’s record of past performance indicates it is likely to

have problems meeting the requirements of the RFP.

Neutral

N No past performance/experience available for evaluation. Offeror has asserted that it has no directly related or relevant past performance experience. Proposal receives no merit or demerit for this factor.

C. PAST PERFORMANCE

Rating Scale:

O - Outstanding G - Good A - Acceptable U - Unsatisfactory N – Neutral.

Place an “X” in the box for the appropriate rating.

Quality
O
G
A
U
N
1
Overall quality of the project
2
Qualifications and quality of key personnel to meet

the objectives of the project

3
Procedures that ensured the level of quality

remained constant throughout the life of the project.

4
Adequacy, relevance and reasonableness of the

quality management approach, procedures, documentation and methods

5
Quality of products, materials and services for the

price paid

6
Accuracy of the record keeping procedure and ability to prepare accurate and timely reports
7
Ability to implement effective corrective actions

and improvements

Comments:

Cost Control
O
G
A
U
N
8
Demonstrated a process for management of the program costs and segmentation of costs for

improved manageability

9
Demonstrated financial stability during the project

performance period

10
Demonstrated effectiveness in reducing project

costs from the baseline cost estimates

11
Demonstrated reasonableness of proposed

modification costs

12
Demonstrated reasonableness in labor and O&M

costs

Timeliness
O
G
A
U
N
13
Timeliness in completing the overall project.
14
Completion of tasks in accordance with project

schedule’s critical milestone dates

15
Timeliness in completing reports
16
Timeliness of responses to client requests and

inquiries

Rating Scale:

O - Outstanding G - Good A - Acceptable U - Unsatisfactory N – Neutral Place an “X” in the box for the appropriate rating.

Business Relations
O
G
A
U
N
17
Demonstrated a business-like concern for your

agency’s / company’s interests

18
Relationship with client technical and functional

personnel

19
Relationship with contracting office personnel
20
Relationship with subcontractors
21
Cooperation and innovation in problem solving
22
Compliance with the terms of the contract
Management
O
G
A
U
N
23
Utilized effective program and project management

processes, tools, and reporting

24
Had satisfactory and complete management plan
25
Demonstrated effectiveness in use of risk

management to proactively reduce project disruptions

26
Ability to retain key personnel
27
Availability and accessibility of key personnel
28
Flexible in responding to changing needs
29
Adequate processes and metrics for the evaluation of their own overall management performance
30
Adequate subcontractor management procedures
31
Demonstrated effectiveness in risk identification,

escalation, response and monitoring procedures

32
Demonstrated effectiveness in capturing incidents

and resolving problems

33
Ability to provide a product or service that met

your mission requirements

Based on this Contractor’s overall performance, would you award them another contract? Why or why not? Did the provided solution from this contractor work and how well did it work?

D. ADDITIONAL REMARKS

Thank you for your assistance in supporting this source selection activity.

File details come from the government source that posted it. Updated .