Attachment_2_-_Past_Performance_Questionnaire.pdf

ATTACHMENT II

PAST PERFORMANCE QUESTIONNAIRE FOR

SOLICITATION NUMBER: AG-3198-S-15-0050

THIS FORM IS PROVIDED FOR THE PURPOSE OF PROVIDING TO

AND SUBMITTAL BY THE VENDORS REFERENCES

Our company is being considered in a Source Selection by the Food and Nutrition Service (FNS), Contract Management Division. It would be appreciated if you would provide comments regarding our past performance. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition Regulation (FAR) prohibits the release of the names of individuals providing reference information about a Vendors past performance. In order to maintain the integrity of the source selection process, respectfully request that you do not divulge the name of the contractor nor discuss your comments on this questionnaire with any other individuals.

This form shall be sent via e-mailed to:

Sean Merritt at: Sean.Merritt@fns.usda.gov and Thu Vo at: Thu.Vo@fns.usda.gov

Email Subject Line: AG-3198-S-15-0050: PAST PERFORMANCE REFERENCE FOR

[INSERT VENDOR NAME]

Past Project Information:

1. Contractor name and address:

2. Project Title and/or Contract Number:

Evaluator (The following information will assist in the analysis of the data. Information will be kept confidential.)

1. Name of Evaluator: ______________________________ Date:_____________

2. Phone Number: __________________ Fax Number:________________

3. Address: ________________________________________________________

4. Position held or function in relation to the project: _______________________ mailto:Sean.Merritt@fns.usda.gov mailto:Thu.Vo@fns.usda.gov

RATINGS:

Please evaluate the contractor’s performance using the following ratings:

Highly Acceptable (HA)

Confidence

Confidence. Based on the vendor’s performance record, essentially no doubt exists that the successful vendor will successfully perform the required effort. Little or no Government oversight is expected to be required in achieving the proposed level of performance.

Acceptable (A)

Confidence

Confidence. Based on the vendor’s performance record, little doubt exists that the vendor will successfully perform the required effort. Little Government oversight is expected to be required in achieving the proposed level of performance.

Unacceptable (U)

Confidence

Confidence. Based on the vendor’s performance record, doubt exists that the vendor will successfully perform the required effort. Significant Government oversight will be expected in achieving the proposed level of performance.

Neutral (N) Vendor without a record of relevant past performance or for whom information on past performance is not available, the vendor may not be evaluated favorably or unfavorably on past performance

Please rate and provide any supporting information for the following: (Use additional sheets as necessary)

1. The relationship between the contractor and the customer’s contract team.

2. The contractor’s on-site management and coordination of subcontractors.

3. The contractor’s overall corporate management, integrity, reasonableness and cooperative conduct.

4. The contractor provided competent program/project manager, supervisor, and workers

5. The contractor’s quality control.

6. The contractor’s ability to meet the performance schedule.

7. The contractor took measures to improve his schedule problems, if any?

8. The contractor’s ability to provide the required work at a reasonable price.

9. The contractor’s compliance with laws, regulations, and policies, if applicable.

10. The contractor rectified identified problems in a timely fashion without further incident of the same.

11. Has the contractor been given any of the following: Cure notice; show cause, letters of reprimand, suspension of payments, termination? If yes, please explain.

12. Would you award another contract to this contractor? If no, please explain.

13. Was the customer satisfied with the end product?

14. Was the contractor provided an opportunity to discuss any negative performance ratings?

If so, what were the results?

15. The contractor maintained a professional working relationship with Government personnel.

16. The contractor was reasonable and cooperative in resolving customer complaints.

17. OVERALL RATING: ____________

Please provide any additional comments.