The file's text, extracted by GovTribe without its formatting.
ATTACHMENT E – PAST PERFORMANCE QUESTIONNAIRE
PART I: FOR COMPLETION BY QUOTER.
Instructions: Quoters are required to complete all items set forth in this Part I for each reference and return the completed forms with the proposal. Quoters are also required to coordinate with their identified references, supplying them with the completed Part I and blank Part II for completion, sufficiently in advance of the due date identified in Part II.
Name and address of individual/firm being evaluated:
Name of firm/agency for which the referenced work was performed:
| Description of firm/agency (check one): |
| Commercial |_| |
| Federal Government |_| |
| Local/state Government |_| |
Address of firm/agency:
Name, title, employer, and contact information for individual providing reference:
Contract number:
Period of performance:
Contract award date:
Contract amount:
| Contracting method: |
| Sealed bid |_| |
| Negotiated |_| |
| Contract type: |
| Firm Fixed Price (FP) |_| |
| FP Incentive |_| |
| FP Economic Price Adjustment |_| |
| Cost Plus Award Fee |_| |
| Cost Plus Fixed Fee-Completion |_| |
| Cost Plus Fixed Fee-Term |_| |
| Cost Plus Incentive Fee |_| |
| Indefinite Delivery/Indefinite Quantity |_| |
| Basic Ordering Agreement |_| |
| Requirements |_| |
| Labor Hour |_| |
| Time and Material |_| |
| Competition: |
| Competitive |_| |
| Non-competitive |_| |
| Prime Contractor |
| Yes |_| |
| No |_| |
Description of the contract work:
Relevance of the referenced contract to the current requirement:
PART II: FOR COMPLETION BY REFERENCE.
Instructions: References are asked to complete all items set forth in this Part II and return the completed form no later than 07/07/2019, at 5:00pm EST. Responses can be sent directly to the Government Point of Contact identified in the combined synopsis/solicitation via electronic mail (rachelle.colon-serna@sba.gov). Confirmation should be sent to the Quoter that the past performance questionnaire was completed. The reference is not required to provide the Quoter with their actual responses and ratings.
Background Information
Name of respondent:
Position and title:
Employer name:
Employer’s address:
| Contact information: |
| Telephone: |
| Fax: |
| E-mail: |
Basis of qualification to evaluate contractor’s performance:
Contract number:
Contract award date:
Contract completion date:
Contract amount:
| Was a subcontracting plan required? |
| Yes |_| |
| No |_| |
Names of key contractor personnel:
Description of the contract work:
Evaluation
For each performance element identified below, references should evaluate performance of the firm or individual identified in Part 1 of this form. Where the reference lacks sufficient information to provide an evaluation for a particular performance element, this should be noted. Where any deficiency or unfavorable information is identified, the reference should identify any mitigating factors that may weigh in favor of the person/firm on whose behalf the reference is provided (i.e., problems due to causes outside the contractor’s control). An individual within your organization who is knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.
| Date this questionnaire completed: |
| Signature of Reference: |
Please provide answers to the questions listed below. When responding to the questions listed, circle the letter that most accurately describes the contractor’s performance or situation (see the “ratings” chart below for a description of each letter). For any neutral, marginal, or unsatisfactory rating, please provide explanatory narratives in the remarks block. These narratives need not be lengthy, just detailed. If a question is not applicable, circle N/A. If you circle a Yes/No answer that is marked with an asterisk (*), please provide a corresponding explanation in the remarks block. If more space is required, use the back of the questionnaire or attach additional pages. Handwritten responses to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.
Evaluation Definitions
| Exceptional |
| Very Good |
| Satisfactory |
| Neutral |
| Marginal |
| Unsatisfactory |
| Performance met all contract requirements and exceeded many. Problems, if any, were negligible, and were resolved in a timely and highly effective manner. |
| Performance met all contract requirements and exceeded some. There were few minor problems, which the contractor resolved in a timely, effective manner. |
| Performance met contract requirements. There were some minor problems, for which corrective actions taken by the contractor were satisfactory. |
| Contractor has no record of past performance, or the record is inconclusive. |
| Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective. |
| Performance did not meet contractual requirements. There were serious problems, and the contractor’s corrective actions were ineffective. |
PERFORMANCE ELEMENTS:
A. QUALITY OF SERVICE
Rating
| 1. |
| Ability of the Quoter to ensure that basic requirements are properly performed in accordance with the contract. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| Quoter’s ability to effectively control the quality of services provided. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| Ability of the Quoter to prepare and maintain work schedules. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 4. |
| Ability of the Quoter to manage and supervise employees so they act in a professional manner, adhere to standards of conduct and all other standards stated in the Contract. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 5. |
| Ability of the Quoter to provide sufficient personnel to effectively perform the Contract requirements (i.e., proving backups, replacing departing personnel). |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 6. |
| Ability of the Quoter to provide sufficient personnel above the basic Contract requirements to meet emergency or temporary additional workload requirements. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 7. |
| Ability of the Quoter to perform at the proposed Contract price or amount. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 8. |
| Ability of the Quoter to develop and/or implement an effective Quality Assurance Program. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 9. |
| Overall rating of contractor’s quality of service. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
B. TIMELINESS OF PERFORMANCE (SCHEDULE)
Rating
| 1. |
| Contractor’s ability to meet specific response times and scheduled timeframes for completion of specific tasks. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| Contractor’s responsiveness/timeliness for providing administrative reports/documents required by the contract. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| Overall rating of contractor’s responsiveness/timeliness. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
C. BUSINESS RELATIONS/CUSTOMER SATISFACTION
Rating
| 1. |
| Contractor’s ability to identify problems and potential problems, and promptly notify the Contracting Officer. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| Contractor’s ability to correct problems and prevent or mitigate potential problems in a timely manner. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| Contractor’s willingness to improve and correct noncompliance issues or concerns. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 4. |
| Contractor’s ability to use effective approaches and provide technical expertise and resources to solve contract problems. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 5. |
| Extent to which the contractor has demonstrated reasonable and cooperative behavior. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 6. |
| Contractor’s effectiveness in interfacing with the Contracting Officer, quality assurance personnel, and customers. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 7. |
| Contractor’s flexibility in satisfying the requirements of its customers. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 8. |
| Extent to which the contractor provided prompt and courteous service when responding to customer complaints. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 9. |
| Overall rating of customer satisfaction. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 10. |
| Overall rating of business relations. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
D. MANAGEMENT OF KEY PERSONNEL
Rating
| 1. |
| Contractor’s ability to select and retain cooperative and effective key personnel, such as the Project Manager and Quality Control Personnel. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2. |
| Extent to which key personnel were knowledgeable about contractual requirements. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 3. |
| Contractor’s ability to provide continuity of key personnel on the contract. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 4. |
| Contractor’s ability to replace key personnel in a timely fashion. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 5. |
| Level of functional expertise of the contractor’s staff. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 6. |
| Overall rating of contractor’s management of key personnel. |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
F. CONTRACTUAL CONSIDERATIONS
Answer/Rating
| 1 |
| How would you rank the overall quality of services you received from the Quoter? |
| E |
| VG |
| S |
| N |
| M |
| U |
| N/A |
| 2 |
| Has an election ever been made not to exercise an option or continue relations due to contractor’s poor performance? |
| YES* |
| NO |
| 3 |
| Has a Contract Discrepancy Report ever been issued? |
| YES* |
| NO |
| 4 |
| Has a cure notice or show cause notice ever been issued? |
| YES* |
| NO |
| 5 |
| Has this contract been partially or completely terminated for default or convenience? |
| YES* |
| NO |
Partially ________ Completely _________
| 6 |
| Are there any pending terminations? |
| YES* |
| NO |
| 8 |
| Would you hire this contractor again? |
| YES* |
| NO |
*REMARKS
Please use this remarks block to provide explanatory narratives for any neutral, marginal, or unsatisfactory rating as well as for any Yes/No answer that is marked with an asterisk (*). These narratives need not be lengthy, just detailed.
