Att. C_Performance Survey.pdf

A . C_Performance Survey

RFQ # 15A00024Q00000093

FOR OFFICIAL USE ONLY

PAST AND PRESENT PERFORMANCE SURVEY

1. Contractor Name:

2. Contract Number:

3. Role on Project:

4. Contractor Address:

5. Contract Type:

Firm Fixed Price T&M/LH

6. Procuring Agency/Company Name:

7. Agency/Company POC:

Phone:

Email:

8. Period of Performance

9. A. Dollar Amount of Award: $ B. Annual Amount: $ C. Total Dollar Value w/ Modifica ons:$

10. Title of Contract

11. Descrip on of Contract Service/Scope of Contract:

Cost Reimbursement Other (Please Specify)

If Other (Please Specify):

FOR OFFICIAL USE ONLY

12. Complexity of Work:

13. Past Performance Evalua on Criteria Comments (Mandatory, A ach addi onal sheets, if necessary)

a. Quality of Service To Consider: *Contractor's ability to meet minimum quality standards specified for performance.

*Contractor's ability to effec vely control the quality of services provided.

*Contractor's compliance with contractual terms and condi ons.

b. Timeliness of Performance To Consider: *Contractor's ability to meet specific response mes and scheduled meframes for comple on of specific tasks.

*Contractor's responsiveness/ meliness for providing administra ve reports/documenta ons required by contract.

*Contractor's meliness in responding to emergency services requirements.

c. Business Rela ons To Consider: *Contractor's ability to iden fy problems and poten al problems and promptly no fy the Contrac ng Officer.

*Contractor's ability to correct problems and prevent or mi gate poten al problems in a mely manner.

*Contractor's willingness to improve and correct noncompliance issues or concerns.

*Contractor's ability to use effec ve approaches and provide technical exper se and resources to solve contract problems.

*Extent to which the contractor demonstrated reasonable and coopera ve behavior.

*Contractor's working rela onship with the Contrac ng Officer, quality assurance personnel, and customers.

*Contractor's flexibility in sa sfying the requirements of its customers.

*Extent to which the contractor provided prompt and courteous service when responding to customer complaints.

d. Management Of Key Personnel To Consider: *Contractor's ability to select and retain coopera ve and effec ve key personnel, such as the contract manager and quality control personnel.

FOR OFFICIAL USE ONLY

*Extent key personnel were knowledgeable about contractual requirements.

*Contractor's ability to meet appropriate staffing levels with qualified personnel in order to provide required services.

e. Compliance with Environmental, Safety, Health, and Security Requirements

To Consider: *Has the contractor ever received any No ces of Viola ons for noncompliance with environmental laws or regula ons?

*Contractor's compliance with safety requirements.

*Contractor's compliance with health requirements.

*Contractor's compliance with security requirements.

f. Contractual Considera ons To Consider: *Has an election been made not to exercise an option or continue relations due to contractor's poor performance?

*Has a Contract Discrepancy Report ever been issued?

*Has a Cure No ce or Show Cause No ce ever been issued?

*Extent to which the contractor provided reliable, supportable cost es mates or proposals.

g. What Is Your Overall Assessment?

14. Would you select this contractor again? Please explain your response.

15. Name:

Date:

16. Title: