Attachment J.5 Past Performance .docx
DOCX document 16 KB Posted
- Attached to
- WTCHP Comprehensive Cost Avoidance, Coordination of Benefits, and Recovery Program Federal contract opportunity
- Solicitation number
- 75D301-20-R-67859
About this file
This document contains a past performance questionnaire template and details of a federal contract opportunity for a comprehensive cost avoidance, coordination of benefits, and recovery program. The past performance questionnaire is to be completed by references for an offeror bidding on the federal contract opportunity. The federal contract opportunity is issued by the Department of Health and Human Services Centers for Disease Control and Prevention Office of Acquisition Services. It seeks to establish a comprehensive cost avoidance and recovery platform from pre- to post-payment processes, including primary insurance identification and validation, coordination of benefits, recovery of incorrectly paid claims from private insurers, participation in New York's workers compensation matching program, and provision of performance metrics and payment integrity services. Responses are due as per the Request for Proposal and its attachments.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment J.7 Business Template.xlsx | XLSX spreadsheet | |
| Attachment J.1 SOO.docx | DOCX document | |
| RFQ 75D301-20-R-67859 Amendment One .pdf | ||
| Attachment J.2 Template Performance-Work-Statement.docx | DOCX document | |
| Attachment J.1 SOO.docx | DOCX document | |
| Attachment J.6 Responses to Pre-Solicitation Questions.xlsx | XLSX spreadsheet | |
| Attachment J.3 BAA Template.docx | DOCX document | |
| Attachment J.2 Template Performance-Work-Statement.docx | DOCX document | |
| Attachment J.1 SOO.docx | DOCX document | |
| Attachment J.4 HHS SubK Plan Template.pdf | ||
| RFQ 75D301-20-R-67859.pdf |
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Text version
Attachment 5 – Past Performance Questionairre
PART I – Past Performance Contact Information [to be completed by Offeror]
Instructions: The Offeror shall complete Part I of this Attachment for each past performance reference. The Contractor shall forward this form (with a completed Part I) to each of its references for completion, with instructions to forward the completed questionnaire to the Contracting Officer (NOT BACK TO THE CONTRACTOR) before the time set for receipt of proposals. Scale 1-10 (1 = least favorable, 10 = most favorable). The completed questionnaires should be forwarded by email directly from the Contractor’s reference to Lauren Peel, Contracting Officer, at Lpeel@cdc.gov
Contractor Information
Company Name:
Company Address:
Past Performance Reference Information
Agency/Organization Name:
Name of Reference Provider:
Title of Reference Provider:
Telephone Number:
Fax Number:
Email Address:
Contact Information
Contract Number:
Contract Total Dollar Value:
Period of Performance (POP):
Performance Location:
| Type of Contract: (Check all that Apply) |
| FFP: |
| T&M: |
| Cost Reim: |
Other:
Description of Services:
Survey Questions
1. What was your experience of the quality of the service provided by this Contractor?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
2. What was your experience with the Contractor’s adherence to contract schedules?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
3. What was your experience with the Contractor’s ability to report on a timely manner?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
4. What was you experience with the Contractor’s ability to recruit quality SME’s?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
5. What was your experience with the Contractor’s ability to adhere to all contract requirements?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
6. What as your experiences with the Contractor’s standards of professionalism?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
7. What was your experience with the Contractor’s ability to control and report costs and work with you to limit additional costs?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
8. What was your experience with the Contractor’s integrity and business ethics?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
9. What was your experience with the Contractor’s spirit of cooperation and fairness of business dealing with you?
Bold, Circle, or Underline a Rating: 1 2 3 4 5 6 7 8 9 10 N/A
10. Please provide any additional comments concerning performance.
File details come from the government source that posted it. Updated .