Attachment 4- Past Performance Questionnaire.pdf

ATTACHMENT 3: PAST PERFORMANCE QUESTIONNAIRE

PART I (TO BE COMPLETED BY OFFEROR REQUESTING THE REFERENCE)

A. OFFEROR INFORMATION

Offeror Name:

Offeror Address:

B. CONTRACT IDENTIFICATION

Project Title:

Contract Number:

Agency/Customer:

Agency/Customer POC Name:

Agency/Customer POC Email Address

Contract/Order/Subcontract/Other:

Contract Type:

Contract Purpose (e.g., Service, Supply, Deveopment/First Article, R&D)?

Contract Award Date:

Period of Performance

Total Contract Value:

Value of Offeror’s Share

Was the Offeror a Prime Contractor? Yes No

Was the Offeror a Sub Contractor? Yes No

Competitive Award? Yes No

Program Title and nature of the effort (i.e., describe the scope of the effort, the type of tasks involved, labor skills used, and products/support delivered).

PART II (TO BE COMPLETED BY RESPONDENT)

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Commentary to support very high or very low rating should be noted on page 5.

Assign each area a rating of, 4 (Outstanding), 3 (Good), 2 (Satisfactory), and 1 (Unsatisfactory). Use the attached Rating Guidelines which is provided as Exhibit 1 as guidance in making these evaluations. Circle the appropriate rating.

A. IDENTIFICATION OF RESPONDENT

Name:

Title:

Telephone Number:

Address:

Email:

B. EVALUATION

QUALITY OF SERVICE:

# Category Rating

1 2 3 4 N/A

1 Compliance with contract requirements

2 Accuracy of reports

3 Level of knowledge, experience, and training of personnel

4 Capability of obtaining personnel to perform required services

5 Effectiveness of personnel in performing required services

6 Overall quality of service

TIMELINESS OF PERFORMANCE:

Rating

1 2 3 4 N/A

1 Reliability

2 Responsive to technical direction

3 Meets contract delivery schedules and/or task deadlines

COST CONTROL:

Rating

1 2 3 4 N/A

1 Current, accurate and complete billings

2 Relationship of negotiated costs to actuals

3 Cost effectiveness

PROGRAM MANAGEMENT:

Rating

1 2 3 4 N/A

1 Adequate and complete management plan

2 Specific management team dedicated to this project

Indications that the provided team had experience in subcontractor management and surveillance

CUSTOMER RELATIONSHIP:

Rating

1 2 3 4 N/A

1 Effective management, including subcontracts

2 Reasonable/cooperative behavior

3 Responsive to contract requirements

4 Notification of problems

5 Flexibility

6 Proactive vs. reactive

OVERALL CUSTOMER SATISFACTION:

Rating

1 2 3 4 N/A

1 Overall Customer Satisfaction

ADDITIONAL COMMENTS:

If rated below a 3, please provide additional comments below to justify rating(s).