AG-3144-S-14-0011_Attach4_-_USDA_Past_Performance_Questionnaire_4_4_14.docx

Source Selection Sensitive: Once completed, please safeguard in accordance with FAR 3.104-4 AG-3144-S-14-0011 Past Performance Questionnaire Please send completed questionnaires directly to USDA Contracting Officer at jason.kattman@ftc.usda.gov

Dear Fellow Customer, Thank you for providing your honest input into the USDA’s source selection process. We understand your response to this request takes precious time and energy; we guarantee the information we are requesting is of utmost importance and enables the USDA to select the vendor offering the best value to the government.

We will not release the source of the information provided, however you are advised vendors will be given an opportunity to respond to adverse past performance information if not previously addressed (via CPARS or other method).

If you have any questions please feel free to contact me, Best Regards, Jason A. Kattman Contracting Officer 970-295-5428 jason.kattman@ftc.usda.gov

This evaluation shall be completed by the customer organization receiving the applicable products and services.

If the USDA determines the vendor being evaluated was involved in drafting the response in any manner, the past performance relating to this questionnaire will be excluded from consideration.

The following contact information helps us track responses received, as well as resolve whatever differences may arise between your perception of the contractor’s performance and the contractor’s perception of their performance. The USDA may contact you with additional questions if required during the evaluation process.

CONFIDENTIAL

Evaluator’s Name:

Title/Role:

Telephone Number:

Organization, Office Symbol, and Address:

Length of involvement in the contract:

Date of questionnaire completion:

EVALUATION RATING SYSTEM

1. The attached questionnaire shall be utilized in the evaluation process of each past performance evaluation. After each factor has been rated in a particular section the evaluator will assign an overall risk rating to the section. The following criteria shall be considered when rating each part of the questionnaire:

Exceptional (E):

Performance meets all or exceeds many of the contractual requirements. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the vendor were highly effective.

Very Good (VG):

Performance meets all or exceeds some of the contractual requirements. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the vendor were effective.

Satisfactory (S):

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the vendor appear or were satisfactory.

Marginal (M)

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the vendor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective.

Unsatisfactory (U):

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Unknown (N/A):

Did not observe performance in this area.

Please respond to the following questions regarding the contractor’s past performance. For all ratings, if applicable please provide a narrative explaining how the vendor either exceeded your requirement or how the vendor failed to meet your requirement.

If the vendor had problems in a specific area, but you determined them not to have had an impact to the mission, please state such in you narrative remarks.

If no rating higher than satisfactory was capable of achievement, please make a short note of that in the narrative section.

NOTE REGARDING DEFINITION OF “CONTRACT”: If the vendor has been performing without a contract but providing services in a long-term manner to your organization using the purchase card as a payment method please note this and complete as if under a singular contract.

Project Identification

a. Contractor’s Name:

b. Contract Number:

c. Program Title:

d. Contract Type:

Firm Fixed Price |_|

Fixed Price Incentive |_|

Labor Hour/Time and Materials |_|

Cost-Plus Award Fee |_|

Cost-Plus Incentive Fee |_|

Other |_| Please explain:

e. Period of Performance:

1. Total Contract Dollar Value (as of this date):

1. Total Number of Vendor Personnel working simultaneously (as of this date):

1. Brief Description of Contracted Item(s) or Service(s):

Quality Related Questions:

1. How well did the vendor manage the program overall?

Narrative:

2. Please rate the vendor’s ability to provide certified and/or qualified interpreters.

3. Please rate the vendors ability to ensure interpretive provided quality services

3.1. Please rate the vendor’s ability to ensure interpreters were professional in appearance and behavior.

3.2. Please rate the vendor’s ability to ensure interpreters were time.

3.3. Please rate the vendor’s quality control program.

3.4. Did the vendor provide interpreters that were not qualified at any point during the period of performance?

If Yes, Please Explain:

How often did this happen?

How were these situations handled?

Was this issue ongoing? If so, what measures were taken to remedy the situation? Were these measures effective?

4. How well did the vendor manage service scheduling?

I

5. How well did the vendor handle communications between your organization, their interpreters, customers and other stakeholders?

I

Complexity:

6. How complex of a management approach was required?

Narrative: (please describe number of personnel, locations, timeframe of requests etc)

7. Was this contract nation-wide?

8. On average how many interpreters were employed on this contract during a normal operations period? (not over life of contract)

9. How many different internal organizations were served under this contract?

10. How many individuals received accommodations under this contract?

General:

11. Please rate the overall achievement of the objectives of the contract.

12. Please rate the contractor’s emphasis on customer satisfaction.

13. Please rate the contractor’s ability to problem solve and provide solutions required to overcome performance issues or other adversity.

14. Please rate the contractor’s overall compliance with the contract terms and conditions and contract administration abilities.

15. In your assessment, what, if any, would you consider the contractor’s strong points and what did you prefer the most about their performance:

16. In your assessment, what, if any, would you consider the contractor’s weak points and what did you prefer least about their performance:

17. Based on your judgment of the contractor’s performance during the period of performance they were under contract with you, would you award the vendor another contract? Please explain.

18. Please provide any additional comments or remarks you feel may be useful in evaluating the respective contractor below:

19. If the vendor provided CART captioning services please rate the vendor’s performance in terms of quality and compliance with contract terms and conditions.

20. If the vendor provided Typewell Transcription services please rate the vendor’s performance in terms of quality and compliance with contract terms and conditions.

Source Selection Sensitive: Once completed, please safeguard in accordance with FAR 3.104-4