Attachment_4_-_Past_Performance_Questionnaire_(2).pdf

AG-SPEC-S-16-0028

Attachment 4

PAST PERFORMANCE QUESTIONNAIRE

Instructions:

• The Contracting Officer will complete Section I and II.

• The Assessor will complete Sections III-VII.

Message to the Assessor: Your assistance is requested by the NRCS to assist with providing feedback regarding the past performance of the Contractor named below. In efforts to expedite receipt of the requested information, the Contracting Officer respectfully requests that you do not mail hard copies.

Instead, please e-mail the completed questionnaire(s) to: vicki.supler@wdc.usda.gov and c/c amber.paschal@wdc.usda.gov by October 07, 2016 NLT 1700 ET. Please sign and date the last page.

I. NRCS Solicitation Information Solicitation Number AG-SPEC-S-16-0028 Project/Requirement National Administrative Services Contract Agency Natural Resources Conservation Services Project/Requirement Description

Non-Personal Administrative Support Services to be provided at various NRCS locations throughout the United States

II. Contract Information for Past Performance Reference CONTRACTOR NAME Contract No

Period of Performance/Delivery Schedule

Project/Requirement Description

Please select from the following as it applies to this contract:

Contracting Role

PRIME SUBCONTRACTOR

III. Assessor Information Assessor Name Title Phone Number/Email Address

Identify your role in the contract award or administration and the period of your involvement.

Role Period of Involvement

Contracting Officer

Contract Specialist

Contracting Officer’s Representative (COR)

Other (please note)

IV. Evaluation Definitions

The following definitions must be used in your assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements to the Government’s benefit. 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.

V. Performance Evaluation

Performance Elements Exceptional Very Good Satisfactory Marginal Unacceptable N/A

Technical Quality

Subcontract & team management

Cost control & savings

Customer satisfaction & responsiveness

Performance schedules

Adapting to changed conditions

Timeliness of reports

VI. Overall Rating of Contractor’s Performance

Exceptional Very Good Satisfactory Marginal Unsatisfactory

VII. General Comments Any comments are appreciated; however, at a minimum please provide rationale for ratings of marginal or unsatisfactory for both the individual element and overall ratings.

Assessor’s Signature Date

Assessor’s Name