Attachment_J-5.pdf

PAST PERFORMANCE QUESTIONNAIRE

Instructions to Offeror for sending References Questionnaire Forms:

Prepare and send a reference questionnaire package for each project you list as a reference for the Past Performance evaluation factor. You are encouraged to send a questionnaire to other clients of contracts. For Government contracts, send to Contracting Officer or Technical Representative. For commercial references send to personnel with duties similar to those for Government contracts. It is your responsibility to follow-up and to encourage your references to send in their questionnaire.

If you have multiple references at one location, send one cover letter and questionnaire for each contract you want a reference for. Your questionnaire package should contain the following.

Cover Letter (See Example).

Respondent Information Rating Sheets.

Offeror should put name in spaces indicated and ensure it is on every page for identification purposes.

Suggested – Pre Addressed stamped envelope to return to the Contracting Officer.

Offeror should place their name on the top of each questionnaire page.

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT

QUESTIONNAIRES.

Attachment J-5. AG-82X9-S-17-0003 Page 1 of 4

SAMPLE TRANSMITTAL LETTER

Your Company Letterhead

Date

To:

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the USDA Forest Service, Rocky Mountain Region, Nebraska National Forest, Charles E. Bessey Nursery, 40637 River Loop, Halsey, Nebraska 69142. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm’s past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to the following address to arrive NOT LATER THAN March 1, 2017. Do not return them to our company.

USDA Forest Service Rocky Mountain Region, Acquisition Management Attn: Howard Redden, Contracting Officer 740 Simms Street Golden, Colorado 80401

If you have any questions regarding the attached questionnaire, or require assistance, please contact Howard Redden @ (303) 275-5288, or hredden@fs.fed.us . Thank you for your assistance.

Signature and Title

Attachment J-5. AG-82X9-S-17-0003 Page 2 of 4

PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Name: 2. Contract Number:

3. Contractor Address: 4. Contract Type:

_______ Firm Fixed Price

_______ Cost Reimbursement

_______ Other (Please Specify)

5. Agency Name: 6. Agency POC/Phone/Fax:

7. Period of Performance: 8. Dollar Amount of Award:$

Total Dollar Value with Mods:

9. Title of Contract:

10. Description of Contract Service:

11. Complexity of Work: Difficult:___________ Routine: _____________

Note: Please use adjectival ratings from attached sheet.

12. Evaluation Factor 13. Comments (Att. additional sheets, if necessary) 14. Rating

a. Quality of Work

b. Personnel

c. Subcontractor Mgmt

d. Business Relations

e. Timeliness of Performance

f. Customer Satisfaction

g. Cost/Budget Control

13. Would you select this firm again? If no, please explain. (Att. Additional sheet if necessary.)

14. Name & Date: 15. Title:

Attachment J-5. AG-82X9-S-17-0003 Page 3 of 4

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Poor, fair, Good, and Excellent. Use the following instructions as guidance in making these evaluations. Note:

There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”

Ratings Quality of

Work/Personnel/ Service

Cost Control Timeliness of Performance

Business Relations/Sub Contractor Mgmt

-Compliance w/contract requirements -Accuracy of reports -Appropriateness of personnel -Technical excellence

-Within budget -Current, accurate, complete billings -Relationship of negotiated costs to actual -Cost efficiencies -Change Orders issued

-Met interim milestones -Reliable -Responsive to technical direction -Completed on time

-Effective Mgmt -Businesslike correspondence -Responsive to contract requirements -Prompt notification of problems -Reasonable/ cooperative -Flexible -Pro-active -Effective SB/ SDB Subcontract Program

Unsatisfactory Quality problems are comprising the achievement of contract requirements

Cost issues are comprising performance

Delays are compromising achievement of contract requirements

Response is not effective

Poor Quality problems require major agency resources to ensure achievement of contract requirements

Cost issues require major agency resources to ensure achievement of contract requirements

Delays require major agency resources to ensure achievement of contract requirements

Response is marginally effective

Fair Quality problems require minor agency resources to ensure achievement of contract requirements

Cost issues require minor agency resources to ensure achievement of contract requirements

Delays require minor agency resources to ensure achievement of contract requirements

Response is somewhat effective

Good Quality problems do not impact achievement of contract requirements

Cost issues do not impact achievement of contract requirements

Delays do not impact achievement of contract requirements

Response is usually effective

Excellent There are no quality problems

There are no cost issues

There are no delays

Response is effective

Attachment J-5. AG-82X9-S-17-0003 Page 4 of 4