Attachment_5_-_Past_Performance_Information_Questionnaire.pdf

PAST PERFORMANCE INFORMATION

CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

OMB Clearance No. 9000-0142 Source Selection Information

Please complete the following questionnaire and return via e-mail to the attention of:

Isaac Bellamy by (Name) (Date)

Isaac.Bellamy@nih.gov (E-mail Address)

This survey pertains to:_______________________________________________________________________________ (Name of Company being evaluated)

Department/Component:

Contract Number: Date of Survey:

Name of Person Completing Survey:

Signature of Person Completing Survey:

Your Company/Agency:

Your Role in this Contract (circle one):

Contracting Officer Contract Specialist Project Officer Other

Contract Value (including options): $

Performance Period:

(including option periods)

Type of Contract:

Approximate percentage of work being performed (or completed) by subcontractor(s): %

Attachment 5

Attachment 6

CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

OMB Clearance No. 9000-0142 Source Selection Information

Information on subcontractor(s) (where more than 25 % of work was completed by the subcontractor):

Subcontractor Program Manager and Phone

Subcontractor Program Manager and Phone

Subcontractor Program Manager and Phone

General description of products/services required under the contract:

RATINGS

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 rating shall be noted on page 4.

Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent), or 5 (Outstanding). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the contractor to make a determination on any of the performance criteria below, please circle "N/A" (not applicable/no opinion).

QUALITY OF SERVICE

1. Compliance with contract requirements

0 1 2 3 4 5 N/A

2. Accuracy of reports 0 1 2 3 4 5 N/A

3. Effectiveness of personnel 0 1 2 3 4 5 N/A

4. Technical Excellence 0 1 2 3 4 5 N/A

5. Effectiveness of the on-site Program Manager 0 1 2 3 4 5 N/A

Attachment 6

CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

OMB Clearance No. 9000-0142 Source Selection Information

COST CONTROL

1. Record of forecasting and controlling target costs

0 1 2 3 4 5 N/A

2. Current, accurate and complete billings

0 1 2 3 4 5 N/A

3. Relationship of negotiated costs to actuals

0 1 2 3 4 5 N/A

4. Cost efficiencies

0 1 2 3 4 5 N/A

TIMELINESS OF PERFORMANCE

1. Met interim milestones

0 1 2 3 4 5 N/A

2. Reliability

0 1 2 3 4 5 N/A

3. Responsive to technical direction

0 1 2 3 4 5 N/A

4. Completed on time including wrap-up and contract administration

0 1 2 3 4 5 N/A

5. Met delivery schedules

0 1 2 3 4 5 N/A

6. Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS

1. Effective management, including management of subcontracts

0 1 2 3 4 5 N/A

2. Reasonable/cooperative behavior

0 1 2 3 4 5 N/A

3. Responsive to contract requirements

0 1 2 3 4 5 N/A

4. Notification of problems

0 1 2 3 4 5 N/A

5. Flexibility

0 1 2 3 4 5 N/A

6. Pro-active vs reactive

0 1 2 3 4 5 N/A

7. Effective small/small disadvantaged business subcontracting program

0 1 2 3 4 5 N/A

NIH CONTRACTOR PERFORMANCE RFP CUSTOMER SURVEY QUESTIONNAIRE

CUSTOMER SATISFACTION

1. The contractor is committed to customer satisfaction.

Yes No (circle one)

2. Would you recommend selection of this firm again?

Yes No (circle one)

ADDITIONAL COMMENTS

NIH CONTRACTOR PERFORMANCE RFP CUSTOMER SURVEY QUESTIONNAIRE

Rating Guidelines

QUALITY OF

PRODUCT OR

SERVICE

COST CONTROL TIMELINESS OF

PERFORMANCE

BUSINESS

RELATIONS

0-Unsatisfactory

Contractor is not in compliance and is jeopardizing achievement of contract objectives

Contractor is unable to manage costs effectively

Contractor delays are jeopardizing performance of contract objectives

Response to inquiries, technical/ service/ administrative issues is not effective

1-Poor Major problems have been encountered

Contractor is having major difficulty managing costs effectively

Contractor is having major difficulty meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is marginally effective

2-Fair

Some problems have been encountered

Contractor is having some problems managing costs effectively

Contractor is having some problems meeting milestones and delivery schedule service/ administrative issues is somewhat effective

3-Good

Minor inefficiencies/ errors have been identified

Contractor is usually effective in managing costs

Contractor is usually effective in meeting milestones and delivery schedule service/ administrative issues is usually effective

4-Excellent

Contractor is in compliance with contract requirements and/or delivers quality products/services

Contractor is effective in managing costs and submits current, accurate, and complete billings

Contractor is effective in meeting milestones and delivery schedule service/ administrative issues is effective

5-Outstanding: The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as "Excellent."