Attachment 4 - PP Client Verification.pdf

Attachment 4 PAST PERFORMANCE QUESTIONNAIRE

Solicitation# 70FA3025R00000001

Please complete this Questionnaire and e-mail to Contract Specialist:

Hal.Vernon@fema.dhs.gov

We are currently in the process of preparing our proposal for the FEMA Wireline Solicitation Number

70FA3025R00000001. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail to Contract Specialist, Hal.Vernon@fema.dhs.gov.

Questionnaire is due to Hal Vernon no later than 3:00 PM Eastern Standard Time on February 21, 2025. Questionnaire must be submitted directly to the Contract Specialist on company letterhead if faxed or emailed from a corporate email account.

If you will not be available for verification of this past performance evaluation, please indicate another

POC for the contacting officer to contact.

Alternate POC name: ________________________________________

Alternate POC phone number: _________________________________

Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR:

Phone: Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance:

4. Brief description of items provided:

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________

II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions –

The following definitions should be used in the assessment of Contractor performance.

Evaluation Rating for Factor 3(Past Performance)

Rating Definition

Superior Based on the Offeror’s past performance record, essentially no doubt exists that the Offeror will successfully perform the required effort and with no risk associated with the Offeror performing under this contract.

Satisfactory The Offeror’s past performance record indicates that some doubt exists that the Offeror will successfully meet or exceed the requirement.

Neutral The Offeror has no relevant past performance record identifiable upon which to base a meaningful performance rating. A neutral rating will generally apply if an Offeror is a new entity. It does not apply if an Offeror fails to provide sufficient past performance information or responsive references.

Unsatisfactory The Offeror’s past performance record provides substantial doubt that the

Offeror will successfully provide as required.

Past Performance Evaluation

Question 1. Performance

What is your assessment of the Contractor’s ability to meet your requirements?

Excellent Very Good Marginal Unacceptable/Non-compliant

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products in a timely manner?

Excellent

Very

Good Marginal Unacceptable/Non-compliant

Timeliness

Ability to

Resolve

Timeliness

Problems

Question 4. Quality of Shipments

What is your assessment of the Contractor’s ability to meet requirements of shipping (including packing, marking, etc) and the overall quality of the delivery?

Quality of

Shipments

Question 5. Overall Rating of Contractor’s performance

What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

General Comments: