Attachment 12 Contractor_Perf_Form.docx
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- 283-22-1000
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DHHS, SAMHSA: Final ___ Interim___ Report
CONTRACTOR PERFORMANCE INFORMATION
Contractor being EVALUATED:
Contractor Name and Address
1. Contract Number:
2. Type of Contract:
3. Contract Value (Current plus any unexercised options):
4. Period of Performance (including any option periods):
5. Description of Requirement:
6. Ratings. Summarize contractor performance and circle or type in the number below that corresponds to the performance rating for each category. Please see the attachment, which explains the rating scale.
Quality:
Comments:
| Cost Control: |
| 0 |
| Schedule: |
| 0 |
| Management: |
| 0 |
| Customer Service: |
| 0 |
7. Total score:
Evaluated by:
Agency/Organization __________________________________________________ Date ___________________
Name and Title _________________________________________ Telephone number ____________________________
Signature _____________________________________________ E-mail address _______________________________ RFP No. 283-22-1000 Attachment 12: Contractor Performance Information Form
RFP No. 283-22-1000 Attachment 12: Contractor Performance Information Form
| Contractor Performance Evaluation |
| Instructions for Completing Contractor Performance Information Form |
Based on the rating area elements presented below and the rating guidelines on the back of this sheet, please evaluate contractor performance in each of the rating areas. On the “Contractor Performance Information” form, circle (or type in the “Comments” area) the rating from 0 to 4 that most closely matches your evaluation of the contractor’s performance. Please add written comments for each rating. If you wish, you may attach additional comments or information. We would also appreciate your answers to the specific questions, if any, on the back of the form. Please return the form to the address indicated on the back of the form. Thank you for your time and your cooperation.
SAMHSA will use the information from this form to evaluate offerors competing for contract awards. We may release the information from this form to the contractor during negotiations or debriefings. If we release information from this form, we will not release your name to the contractor.
Elements within Each Rating Area
Quality of Product or Service
| - | Compliance with contract requirements |
| - | Accuracy of reports |
| - | Appropriateness of personnel |
| - | Technical excellence |
Cost Control
| - | Within budget |
| - | Current, accurate and complete billings |
| - | Costs properly allocated |
| - | Unallowable costs not billed |
| - | Relationship of negotiated costs to actual |
| - | Cost efficiencies |
Schedule
| - | Meets interim milestones |
| - | Reliable |
| - | Stays on schedule despite problems |
| - | Responsive to technical direction |
| - | Completes work on time, including wrap-up and contract administration |
| - | No liquidated damages assessed |
Management
| - | Effective management |
| - | Use of performance-based management techniques |
| - | Business-like concern for the customer's interests |
| - | Effective management and selection of subcontractors |
| - | Effective small/small disadvantaged business subcontracting program |
| - | Reasonable/cooperative behavior |
| - | Effective use of technology in management and communication |
| - | Flexible |
| - | Minimal staff turnover |
| - | Maintains high employee morale |
| - | Resolves disagreements without being unnecessarily litigious. |
Customer Service
| - | Understands and embraces service and program goals |
| - | Team approach with the customer |
| - | Satisfaction of end users with the contractor’s service |
| - | Positive customer feedback |
| - | Prompt responses |
| - | Courteous interactions |
| - | Effective escalations and referrals |
| - | Initiative and proactive improvements |
| - | Creative service strategies |
Rating Guidelines
Quality of Product or Service:
| 0 - Unsatisfactory |
| Nonconformance jeopardizes the achievement of contract goals; default. |
| 1 - Marginal |
| Nonconformance requires major agency intervention to ensure achievement |
of contract goals; show cause or cure notices.
| 2 - Satisfactory |
| Quality meets specifications in most cases, however, some agency intervention required to ensure achievement of contract requirements. |
| 3 – Very Good |
| Quality meets specifications in all cases. |
| 4 - Exceptional |
| Quality exceeds specifications in some cases. |
Cost Control:
| 0 - Unsatisfactory |
| Cost increases jeopardize achievement of contract goals; or billings routinely include unallowable costs. |
| 1 - Marginal |
| Significant cost increases; or some inaccurate billings including some with unallowable costs. |
| 2 - Satisfactory |
| Minor cost increases; or some inaccurate billings, but a minimal (1-2) number with unallowable costs. |
| 3 – Very Good |
| Contractor performed within costs; but some late billings, none with unallowable costs. |
| 4 - Exceptional |
| Costs were less than the amount cited in the contract; and billings accurate and timely. |
Schedule:
| 0 - Unsatisfactory |
| Delays jeopardize the achievement of contract goals. |
| 1 - Marginal |
| Other significant delays. |
| 2 - Satisfactory |
| Minor delays. |
| 3 – Very Good |
| All deliverables on time. |
| 4 - Exceptional |
| All deliverables on time with some ahead of schedule; or stays on schedule despite unforeseen circumstances. |
Management:
| 0 - Unsatisfactory |
| Unethical or illegal business practices. |
| 1 - Marginal |
| Business practices are not attuned to customer support. |
| 2 - Satisfactory |
| Business practices are somewhat attuned to customer support. |
| 3 – Very Good |
| Business practices focus on customer support. |
| 4 - Exceptional |
| Highly effective, proactive business practices focused on customer support. |
Customer Service:
| 0 - Unsatisfactory |
| Response to service requests is routinely late, ineffective, or rude; customers express frustration or anger about many interactions; complaints are unresolved; contractor seems unaware of service issues. |
| 1 - Marginal |
| Response to service requests is often late, ineffective or rude; some complaints are resolved. |
| 2 - Satisfactory |
| Response to service requests is uneven in timing or effectiveness; customer interactions are tenuous; contractor is trying hard and understands service issues. |
| 3 – Very Good |
| Response to service requests is timely, effective and courteous; customers express positive feedback; delivery of service is smooth and organized; collects customer feedback; customer problems are resolved well. |
| 4 - Exceptional |
| Response to service requests is timely, effective and courteous; the contractor is proactive in building good relations with customers, proposing new service strategies, analyzing and reporting on service loads and collecting and using customer feedback. |
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