Attachment 5- Past Performance Questionnaire.pdf

SOURCE SELECTION INFORMATION

PPQ V3 | May 2022

Attachment 5

PAST PERFORMANCE QUESTIONNAIRE

The United States Senate, Senate Democratic Media Center (SDMC) requests information in support of a source selection of a single award for a Media Asset Management (MAM) environment. When complete, the information on this form is SOURCE SELECTION INFORMATION and shall be protected as procurement sensitive information. Please complete this questionnaire and send within five (5) days of receipt by email to:

acquisitions@saa.senate.gov Attn: Tonia Courtney 2025-R-012 Procurement and Contracting Specialist

A. Contract/Project/Task Order Information. Offeror must complete the information below regarding the contract on which the offeror is seeking a past performance reference:

Name of Offeror/Subcontractor:

Contract/Task Order Number:

Contract Type:

Project Name:

Period of Performance:

Brief Description of Work:

mailto:acquisitions@saa.senate.gov

Attachment J-6

B. Reference Information. Reference must complete the information below regarding the contract on which the offeror is seeking a past performance reference:

Company/Agency Name:

Name of Person Completing Questionnaire:

Signature of Person Completing Questionnaire:

Your Role in Managing this Contract:

Your Phone Number:

Your Email Address:

Time Period of Your Involvement with Contractor:

For each question posed below, please identify (highlight or underline) the response code which best reflects your experience with the referenced contract:

EX Exceptional -- Performance meets contractual requirements and exceeds many to the Company/Agency’s 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.

VG Very Good -- Performance meets contractual requirements and exceeds some to the Company/Agency’s 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.

S 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.

MG 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.

US 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.

N/A Not Applicable or Not Observed

PAST PERFORMANCE QUESTIONNAIRE Solicitation 2024-R-015

1. Assess the contractor’s performance fulfilling contract requirements and specifications.

EX VG S MG US N/A

Comments:

2. Assess the ability of the contractor to deliver goods and services according to contract schedules.

EX VG S MG US N/A

Comments:

3. Assess the contractor’s performance in identifying problems and taking corrective actions.

EX VG S MG US N/A

Comments:

4. Assess the overall expertise, knowledge, and quality of assigned contractor personnel.

EX VG S MG US N/A

Comments:

5. Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

EX VG S MG US N/A

Comments:

6. Assess the effectiveness of the contractor’s overall program management.

EX VG S MG US N/A

Comments:

7. Assess the contractor’s effectiveness in forecasting and managing contractual costs.

EX VG S MG US N/A

Comments:

8. Overall assessment. EX VG S MG US N/A

Comments:

9. Would you contract with this contractor again? ( ) Yes ( ) No

If no, why not?

10. Please provide any further comments that are pertinent to the contractor’s performance.