Attachment 3 - Reference Questionnaire.doc
DOC document 70 KB Posted
- Attached to
- Rural Development (RD) Modernization of the Guaranteed Underwriting System (GUS) 2 Federal contract opportunity
- Solicitation number
- 12SAD123R0004
About this file
This document is a Reference Questionnaire that is part of a solicitation for a U.S. Department of Agriculture (USDA) Rural Development (RD) requirement for the Guaranteed Underwriting System 2 (GUS2) contract.
The reference questionnaire is seeking past performance information from points of contact on recent and relevant efforts performed by the offeror or proposed team members. Responses to the questionnaire must be submitted directly to the USDA contracting office by the solicitation closing date. The solicitation is being conducted as a best value source selection. The contract is a Firm Fixed Price vehicle. Key details include the contract number, value, period of performance, and a brief description of the work. Respondents are asked to rate the contractor's overall performance on a scale from Exceptional to Unsatisfactory and provide comments.
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Reference Questionnaire Solicitation 12SAD123R0004
QUESTIONNAIRE COVER LETTER
LETTERHEAD
FOR OFFICIAL USE ONLY
FROM:
TO:
SUBJECT: Reference Questionnaire for the (CONTRACT AND ORDER NUMBER (IF APPLICABLE) TO BE EVALUATED). The effort was performed by (SPECIFIC ENTITY THAT PERFORMED THE WORK) under (NAICS CODE).
We, (Company Name) are seeking past performance information to assist us in our response to a USDA Rural Development (RD), Request for Proposal (RFP), Solicitation # 12SAD123R0004 Single-Family Housing Guaranteed Loan Program (SFHGLP). The acquisition is being conducted as a best value source selection. The RFP specifically requires that we, as an Offeror, send the attached questionnaire to several points of contact (POC) on recent and relevant efforts that we (or a proposed team member) have performed. As such, please take a few moments of your time to fill out the attached questionnaire.
DO NOT RETURN THE COMPLETED QUESTIONNAIRE TO US. USDA requests that all Offeror’s Reference Questionnaire responses be submitted by electronic mail no later than the solicitation closing date as follows:
To: Camille.Perry@USDA.gov Subject: SFHGLP Reference Questionnaire for (Insert Company Name) Please note that it is the responsibility of the Offeror to confirm that their Reference Questionnaire responses were sent and received by USDA. It is also the responsibility of the Offeror to make sure that the electronic mail responses include in the subject line the Offeror’s name.
Thank you for your timely assistance.
Sincerely, (TITLE AND NAME OF COMPANY OFFICIAL)
NOTE: Offeror to insert information where there is (italics text surrounded by parentheses) in the sample letter.
REFERENCE QUESTIONNAIRE
SOURCE SELECTION SENSITIVE
IAW FAR 2.101 AND 3.104
Solicitation:
CONTRACTOR: __________________________
I. Background
The purpose of this questionnaire is to obtain information relative to contracts that have previously been completed within the past five years or are currently being performed by the contractor identified above. This company is a potential source for performing a Firm Fixed Priced contract.
II. Instructions
Please complete the questionnaire based on the following guidance:
| RATING |
| DESCRIPTION |
| EXCEPTIONAL |
| Performance meets contractual requirements and exceeds many to the Customers benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| VERY GOOD |
| Performance meets contractual requirements and exceeds some to the Customers benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| SATISFACTORY |
| Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| MARGINAL |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented. |
| UNSATISFACTORY |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
III. Experience:
A. Contractor: _______________________________________________
B. Contract Number: __________________________________________
C. Contract Value: _____________________________
D. Period of Performance: _____________________________________
E. Amount your company has invoiced to date:
F. Brief Description of Contract: _____________________________________________________________________________
G. Details of Work Tasks Completed:
IV. Past Performance:
1. How would you rate the contractor’s overall performance?
[ ] Exceptional [ ] Very Good
[ ] Satisfactory [ ] Marginal [ ] Unsatisfactory
Comments: ___________________________________________________________________
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