Attachment 3 - Past Performance Questionnaire.pdf

USCA24R0030

Attachment 3

Administrative Office of the U.S. Courts (AOUSC)

ATTACHMENT 3 - PAST PERFORMANCE QUESTIONNAIRE

USCA24R0030

Please complete this Questionnaire and email it directly to David Kelley Contracting Officer at David_Kelley@ao.uscourts.gov by no later than 12:00 p.m. Eastern Time (ET) on May 31, 2024.

Submissions shall reference the offeror’s name and “RFP USCA24R0030” in the email subject line.

Questionnaires must be submitted by the respondent. Questionnaires submitted by the offeror will not be accepted. Late submissions will not be accepted.

Part 1. TO BE COMPLETED BY OFFEROR – Information about Past Contract

1. CONTRACTOR NAME & ADDRESS: 2. CONTRACT NO.:

3. CONTRACT PERIOD OF PERFORMANCE:

4. CONTRACT VALUE (with options):

5. CUSTOMER POINT OF CONTACT NAME:

6. CUSTOMER EMAIL ADDRESS & PHONE

NUMBER

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

mailto:David_Kelley@ao.uscourts.gov

PAST PERFORMANCE QUESTIONNAIRE

Name of Contractor Being Rated: Contract Number:

Part 2. TO BE COMPLETED BY RESPONDENT

• Please provide information about yourself in blocks 8, 9 and 10.

• You are being asked to rate the identified contractor’s performance within the past three years under the contract referenced above. The information that you provide will be considered during the proposal evaluation process for award of a federal contract.

Therefore, it is important that the information be factual and as accurate as possible. Please use the rating scale in block 11 to answer questions 1 through 4 below about the contractor's performance under the referenced contract during the past three years.

• In addition, you are encouraged to provide examples and/or explanations (use additional pages if necessary) to support adjectival ratings given.

8. EVALUATOR'S NAME, POSITION (CO/Project Manager/ COR/ Other) AND ORGANIZATION:

9. EVALUATOR'S PHONE NUMBER AND E-MAIL ADDRESS:

10. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

11. RATING SCALE FOR CONTRACT PERFORMANCE:

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

Part 3. PAST PERFORMANCE RATINGS (TO BE COMPLETED BY RESPONDENT) Note – When completed, this questionnaire will contain source selection information that should be protected in accordance with Guide to Judiciary Policy Vol. 14 §150.20 Question 1. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

☐ Outstanding (Explanation must be provided in Comments field below) ☐ Good ☐ Acceptable ☐ Marginal (Explanation must be provided in Comments field below) ☐ Unacceptable (Explanation must be provided in Comments field below) Comments:

Questions 2. Effectiveness of Project Management (to include use and control of subcontractors)

☐ Acceptable ☐ Marginal (Explanation must be provided in Comments field below)

Question 3. Timeliness of Performance for Services and Product Deliverables.

☐ Acceptable ☐ Marginal (Explanation must be provided in Comments field below)

Question 4. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

☐ Acceptable ☐ Marginal (Explanation must be provided in Comments field below)

Other Information Sources. Are you aware of other relevant past efforts by this company? If yes, please provide the name and telephone number of a point of contact:

NAME OF RESPONDENT

(Type or print)

SIGNATURE OF RESPONDENT

DATE SIGNED