AG-3142-S-15-0014_J-2_Past_Performance_Questionaire.pdf

PAST PERF ORMANCE QUESTIONNAIRE

Solicitation # AG-3142-S-15-0014

Please complete this Questionnaire and e-mail or fax to Contract Specialist, e-mail Fredrick.Freeman@dm.usda.gov

FAX: 202- 202-720-9226

We, ______________________, are currently in the process of preparing a proposal for the United States Department of Agriculture, USDA, Solicitation Number AG-3142-S-15-0014. As part of our proposal, we have listed you as a reference on our performance for this type of service with your firm or agency under the previous/current contract listed below.

Your input on our performance is therefore requested and much appreciated.

Please complete this Questionnaire and e-mail or fax to Contract Specialist, e-mail Fredrick.Freeman@dm.usda.gov or FAX: 202- 202-720-9226.

Questionnaire is due to Mr. Fredrick Freeman no later than Friday February 20, 2015, noon (ET). Questionnaire must be submitted directly to the Contract Specialist on company letterhead if faxed or emailed from a corporate email account.

If you will not be available on for verification of this past performance evaluation on or about the last two weeks of March 2015, please indicate another POC for the contacting officer to contact.

Alternate POC name: ________________________________________ Alternate POC phone number: _________________________________ Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR: __________________.________

I. CURRENT OR HISTORICAL CONTRACT INFORMATION

CONTRACT REFERENCED:

1. Contract or Identifying Number: _______________________________________________

2. Contract / Task order Amount: ___________________________________________________

3. Performance Period: ______________________________________________

4. Brief project description: ______________________________________________________

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company: ______________________________________________________

Title: _______________________________ Phone: _____________________________

E-mail: _____________________________________________________________________ mailto:Fredrick.Freeman@dm.usda.gov mailto:Fredrick.Freeman@dm.usda.gov

II. EVALUATION.

Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions –

The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE (N/A) Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

III. PAST PERFORMANCE EVALUATION

Question 1. PERFORMANCE

What is your assessment of the Contractor’s ability to meet your requirements?

Exceptional Very

Good Satisfactory Marginal Unsatisfactory N/A

Performance

Comments, if any.

Question 2. TIMELINESS

To what extent were contract performance requirements met? Consider also such things as; contract performance period requirements; provided submittals in a timely manner; timely completion of punch- list items; timely submission of close out documents, i.e., “as builts”. Was timely and satisfactory response to warranty issues after project completion provided?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Timeliness

Question 3. QUALITY OF WORK

Evaluate performance in complying with contract requirements, quality achieved and overall technical expertise demonstrated.

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Quality of Work

Question 4. COORDINATION

How well were subcontractors, subconsultants, suppliers, and/or the labor force managed and coordinated? Or, if firm was a subcontractor, how well did they respond to coordination efforts and work with other subs? Were there any problems and, if so, how were they handled?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Coordination

Question 5. CUSTOMER SATISFACTION:

To what extent were the end users satisfied with: Quality? Cost? Schedule?

Exceptional Q____ C_____S____ Very Good Q____ C_____S____ Satisfactory Q____ C_____S____ Marginal Q____ C_____S____ Unsatisfactory Q____ C_____S____

Question 6:

If given the opportunity, would you work with this firm again?

Yes ___________ No ____________ Not Sure ____________

OTHER REMARKS:

Use the space below to provide other information related to the contractor's performance. This may include selection of subcontractors/subconsultants, flexibility in dealing with contract challenges, payment issues, their overall concern for the client's interest (if applicable), project awards received, etc.