Att. C - Past and Present Performance Survey.docx

DOCX document 24 KB Posted

Attached to
Emergency Ambulance/Medic Services Federal contract opportunity
Solicitation number
15A00023R00000059
Issued by
Department of Justice Bureau of Alcohol Tobacco Firearms and Explosives

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This document is a past and present performance survey for a contractor providing emergency ambulance and medical services to the Department of Justice Bureau of Alcohol Tobacco Firearms and Explosives under Solicitation 15A00023R00000059. The survey collects information on the contractor's performance quality, timeliness, business relations, management of key personnel, compliance with requirements, and overall past performance. Respondents are asked to rate and provide narrative explanations for 14 performance criteria on a scale of Exceptional to Unsatisfactory. The survey also asks yes or no questions regarding notices of noncompliance, discrepancies, cure notices, reliable cost estimates, and whether the agency would hire the contractor again.

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Att A - Pricing Table.xlsx XLSX spreadsheet
Solicitation 15A00023R00000059.pdf PDF
Att. B - Wage Determination.pdf PDF

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PAST AND PRESENT PERFORMANCE SURVEY

FOR OFFICIAL USE ONLY (When Filled In)

A. GENERAL INFORMATION:

Contractor’s Name:

Project Title or Brief Description of Work:

Contract Number Provided by Offeror:

Contract Dollar Amount: $

Types of work performed:

Contract Period or Dates of Performance Provided by Offeror: ___________________________

Contractor performed as the (1) Prime Contractor (2) Sub-Contractor _____________________

B. RESPONDENT INFORMATION (Point of Contact, Agency and Address):

POC Name:

Address:

Agency:

Phone: Fax: ______________ Email Address:

C. EMAIL COMPLETED SURVEY FORM TO: Brian.Wilkins@atf.gov

D. PERFORMANCE INFORMATION: Choose the letter on the scale that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF U OR M.

Solicitation 15A00023R00000059

U
M
N
S
VG
E
Unsatisfactory
Marginal
Neutral
Satisfactory
Very Good
Exceptional
Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.
Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.
No record of past performance or the record is inconclusive.
Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.
Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems which the contractor resolved in a timely, effective manner.
Performance met all contract requirements and exceeded many to the government’s benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner

QUALITY OF SERVICE (Circle Response)

1
Contractor's ability to meet minimum quality standards specified for performance
E
VG
S
N
M
U
N/A
2
Contractor's ability to effectively control the quality of services provided
E
VG
S
N
M
U
N/A
3
Contractor's compliance with contractual terms and conditions
E
VG
S
N
M
U
N/A
4
Overall rating of contractor's quality of service
E
VG
S
N
M
U
N/A

TIMELINESS OF PERFORMANCE (Circle Response)

1
Contractor's ability to meet specific response times and scheduled timeframes for completion of specific tasks.
E
VG
S
N
M
U
N/A
2
Contractor's responsiveness/timeliness for providing

administrative reports/documentations required by contract.

E
VG
S
N
M
U
N/A
3
Contractor's timeliness in responding to emergency services

requirements.

E
VG
S
N
M
U
N/A
4
Overall rating of contractor's responsiveness/timeliness.
E
VG
S
N
M
U
N/A

BUSINESS RELATIONS (Circle Response)

1
Contractor's ability to identify problems and potential problems and promptly notify the Contracting Officer
E
VG
S
N
M
U
N/A
2
Contractor's ability to correct problems and prevent or mitigate potential problems in a timely manner.
E
VG
S
N
M
U
N/A
3
Contractor's willingness to improve and correct noncompliance issues or concerns.
E
VG
S
N
M
U
N/A
4
Contractor's ability to use effective approaches and provide

technical expertise and resources to solve contract problems.

E
VG
S
N
M
U
N/A
5
Extent to which the contractor has demonstrated reasonable

and cooperative behavior.

E
VG
S
N
M
U
N/A
6
Contractor's working relationship with the Contracting Officer,

quality assurance personnel, and customers.

E
VG
S
N
M
U
N/A
7
Contractor's flexibility in satisfying the requirements of its

customers.

E
VG
S
N
M
U
N/A
8
Extent to which the contractor provided prompt and courteous service when responding to customer complaints.
E
VG
S
N
M
U
N/A
9
Overall rating of business relations.
E
VG
S
N
M
U
N/A

MANAGEMENT OF KEY PERSONNEL (Circle Response)

1
Contractor's ability to select and retain cooperative and effective key personnel, such as the contract manager and quality control personnel.
E
VG
S
N
M
U
N/A
2
Extent key personnel were knowledgeable about contractual

requirements.

E
VG
S
N
M
U
N/A
3
Contractor's ability to meet appropriate staffing levels with

qualified personnel in order to provide required services.

E
VG
S
N
M
U
N/A
4
Overall rating of contractor's management of key personnel.
E
VG
S
N
M
U
N/A

COMPLIANCE WITH ENVIRONMENTAL, SAFETY, HEALTH, AND SECURITY REQUIREMENTS (Circle Response)

1
Has the contractor ever received any Notices of Violations for

noncompliance with environmental laws or regulations?

YES

NO

2
Contractor's compliance with safety requirements.
E
VG
S
N
M
U
N/A
3
Contractor's compliance with security requirements.
E
VG
S
N
M
U
N/A

CONTRACTUAL CONSIDERATIONS (Circle Response)

1
Has an election ever been made not to exercise an option or

continue relations due to contractor's poor performance?

YES

NO

2
Has a Contract Discrepancy Report ever been issued?
YES

NO

3
Has a Cure Notice or Show Cause Notice ever been issued?
YES

NO

4
Extent to which the contractor provided reliable, supportable

cost estimates or proposals.

E
VG
S
N
M
U
N/A
5
Overall rating of contractor's performance under this contract.
E
VG
S
N
M
U
N/A
6
Would you hire this contractor again?
YES

NO

WHAT IS YOUR OVERALL ASSESSMENT OF

FACTOR 1, PAST PERFORMANCE? (Circle Response)

E
VG
S
N
M
U
N/A

File details come from the government source that posted it. Updated .