Attachment 5_ Past Performance Rating Form_RFP 75A50226R00024.docx
DOCX document 47 KB Posted
- Attached to
- Emergency Response Wraparound Services
- Solicitation number
- 75A50226R00024
About this file
This is a Past Performance Rating Form template for Solicitation 75A50226R00024, an Emergency Response Wraparound Services procurement by the Department of Health and Human Services Administration for Strategic Preparedness and Response (ASPR). The form is used to evaluate contractor performance on past projects and must be completed by the awarding agency or nongovernmental customer responsible for a project, then returned to the offeror in PDF format so they can incorporate it into their proposal submission.
The form requires performance raters to evaluate contractors across six criteria using a five-point adjectival scale: Technical/Quality of Product or Service, Cost Control, Schedule/Timeliness, Management or Business Relations, Small Business performance, and Regulatory Compliance. Each criterion offers rating options of Exceptional, Very Good, Satisfactory, Marginal, or Unsatisfactory, with Marginal and Unsatisfactory ratings requiring substantiation comments. Cost Control can be marked as N/A with explanation. Completed forms must be emailed to tonya.spratt-williams@hhs.gov. The template requests project identification information including contractor name, contract/order number, project title, and period of performance, along with rater contact details. This is a template document designed to standardize past performance evaluations for proposal evaluation purposes.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 6_Qualification and Certification_RFP 75A50226R000024.docx | DOCX document | |
| Attachment 3A_Self Scoring Worksheet SAMPLE_RFP 75A50226R00024.xlsx | XLSX spreadsheet | |
| Attachment 4_Cost Price Template_RFP75A50226R00024.xlsx | XLSX spreadsheet | |
| Attachment 8_Relevant Experience_RFP 75A50226R00024.docx | DOCX document | |
| Attachment 9_NAICS or PSC Code Change Letter_RFP 75A50226R00024.docx | DOCX document | |
| RFP75A50226R00024.pdf | ||
| Attachment 1_SOW_RFP 75A50226R00024.pdf | ||
| Attachment 2_Offerors Proposal Checklist_RFP 75A50226R00024.docx | DOCX document | |
| Attachment 3_Self Scoring Worksheet_RFP 75A50226R00024.xlsx | XLSX spreadsheet | |
| Attachment 7_ Industry Questions Template_RFP 75A50226R00024.xlsx | XLSX spreadsheet |
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Text version
SOLICITATION NO. 75A50226R00024
ATTACHMENT (5)
PAST PERFORMANCE RATING FORM
INSTRUCTIONS
If applicable and in accordance with Section M.14 of the solicitation, the Offeror must provide this Past Performance Rating Form to the Contracting Officer, Contracting Officer Representative, or Program Manager of the awarding agency or non‑governmental customer responsible for the project. No other format is acceptable. The awarding agency or non‑governmental customer must return the completed form to the Offeror in PDF format so the Offeror can complete the Self‑Scoring Worksheet and submit the form with their proposal. At their discretion, the awarding agency or non‑governmental customer may also provide a copy directly to the Contracting Office by emailing it to tonya.spratt-williams@hhs.gov.
PAST PERFORMANCE PROJECT IDENTIFICATON (To be filled out by the Offeror):
| CONTRACTOR NAME: |
| Click here to enter text. |
| CONTRACT or ORDER NUMBER: |
| Click here to enter text. |
| PROJECT TITLE: |
| Click here to enter text. |
| TOTAL PERIOD OF PERFORMANCE, INCLUDING OPTIONS |
| Click here to enter text. |
PAST PERFORMANCE REFERENCE INFORMATION (To be filled out by the Rater):
| PERFORMANCE RATER NAME: |
| Click here to enter text. |
| TITLE: |
| Click here to enter text. |
| AGENCY or CUSTOMER: |
| Click here to enter text. |
| PHONE: |
| Click here to enter text. |
| Click here to enter text. |
For each of the Five (5) criteria listed below, the rater must choose One (1) Adjectival Rating by checking the box, as applicable. At a minimum, for any rating that is checked Marginal or Unsatisfactory, please submit additional comments to substantiate the rating. If Cost Control is N/A, Please explain why.
1. TECHNICAL/QUALITY OF PRODUCT OR SERVICE
| RATING |
| Adjectival Rating |
| Definition |
Exceptional Performance meets contractual requirements and exceeds many to the Government’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.
Very Good Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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.
ADDITIONAL COMMENTS:
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2. COST CONTROL
| RATING |
| Adjectival Rating |
| Definition |
Performance meets contractual requirements and exceeds many to the Government’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.
Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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
Click here to enter text.
3. SCHEDULE/TIMELINESS
| RATING |
| Adjectival Rating |
| Definition |
Performance meets contractual requirements and exceeds many to the Government’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.
Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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.
Click here to enter text.
4. MANAGEMENT OR BUSINESS RELATIONS
| RATING |
| Adjectival Rating |
| Definition |
Performance meets contractual requirements and exceeds many to the Government’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.
Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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.
Click here to enter text.
5. SMALL BUSINESS
| RATING |
| Adjectival Rating |
| Definition |
Performance meets contractual requirements and exceeds many to the Government’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.
Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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.
Click here to enter text.
6. REGULATORY COMPLIANCE
| RATING |
| Adjectival Rating |
| Definition |
Performance meets contractual requirements and exceeds many to the Government’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.
Performance meets contractual requirements and exceeds some to the Government’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 was effective.
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.
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
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.
Source Selection Information – See FAR 2.101 and 3.104
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