Attachment 41 - Past Performance Questionnaire.docx

United States Patent and Trademark Office Past Performance Questionnaire (PPQ) Solicitation #: 1333BJ20R00151004

Brief Description of Work Being Procured: The U.S. Department of Commerce, U.S. Patent and Trademark Office (USPTO) is seeking highly qualified contract staff with applicable skills, to team with federal staff carrying out patent data and document management services. The offeror shall provide patent data and document management support services to the USPTO.

In order to assess potential offerors under USPTO Solicitation Number 1333BJ20R00151004, the USPTO contracting office is obtaining past performance information with respect to each offeror in the performance of the work described above. As a reference for work performed by the firm identified below in this questionnaire, your candid response will assist in the evaluation process. Please complete the questionnaire as thoroughly as possible.

Please complete and sign. References are to submit fully completed questionnaires to Contracting Specialist Mark Motta and Contracting Officer Heather Watroba via email at mark.motta@uspto.gov and heather.watroba@uspto.gov no later than the Solicitation submission due date of noon ET on Monday, August 10, 2020. The email message shall originate from the reference's government or commercial e-mail system. If you have questions, please contact Contract Specialist, Mark Motta, at (571) 270-0828.

I. Contract Information

a. Company Being Evaluated:

b. Address:

c. Contract Number:

d. Contract Type:

e. Period of Performance (including options):

f. Total Contract Value:

g. Award Information:

Competitive: ( ) Yes ( ) No Basis of Selection: ( ) Technical ( ) Cost/Price ( ) Other (specify):

II. Description of Contract (Briefly describe the services provided under this contract):

III. Under the aforementioned contract, this firm was:

( ) Prime Contractor ( ) Subcontractor ( ) Team Member

IV. Does a corporate or business relationship exist between the firm being evaluated and your organization? If yes, please explain.

( ) Yes ( ) No

V. Evaluator Information

a. Name:

b. Title:

c. Agency/Company:

d. Phone:

e. Role in Program Contract:

f. Length of Involvement in this Program/Contract:

VI. Performance Survey The following are the definitions for the rating system being used:

Excellent (E); Very Good (VG); Good (G); Fair (F); Poor (P); Not Required (NR)

VII. Overall Contract Performance Rating Based on the scoring above:

( ) Excellent ( ) Very Good ( ) Good ( ) Fair ( ) Poor

VIII. Would you select this contractor again?

( ) Yes ( ) No

IX. Please add any other comments you may feel are pertinent.

Rater’s Signature Date