Attachment C - Past Performance Questionnaire.docx
DOCX document 22 KB Posted
- Attached to
- Public Assistance Technical Assistance Contracts V (PA TAC V) Federal contract opportunity
- Solicitation number
- 70FB8023R00000011
- Issued by
- Federal Emergency Management Agency
About this file
This document is a past performance questionnaire for contractors responding to solicitation number 70FB8023R00000011 from the Federal Emergency Management Agency. The questionnaire requests ratings and comments on quality of work, schedule, cost control, management, small business subcontracting, and regulatory compliance for contracts performing similar administrative management and general consulting services. Responses are due by August 21, 2023 and will be used to evaluate contractors for award of public assistance technical assistance contracts to provide support to states, tribes, territories, and local entities applying for FEMA disaster assistance.
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Text version
Past Performance Questionnaire Department Of Homeland Security Federal Emergency Management Agency
SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number: 70FB8023R00000011
Dear Sir/Ma’am;
The Department of Homeland Security is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offeror provide information about their past performance on the same or similar federal, state, or local government or commercial contracts as compared to North American Industry Classification System (NAICS) 541611, entitled Administrative Management and General Consulting Services. You have been identified as the point of contact cited on the enclosure. Your assessment of their performance is extremely valuable to our evaluation.
Please complete the enclosure and return to the Contracting Officer shown below, no later than 10:00 p.m. (ET) on 21 August 2023. Your questionnaire may be submitted directly to the Contracting Officer at (fema-patacv@fema.dhs.gov).
Your cooperation is greatly appreciated. Questions may be directed to the undersigned at fema-patacv@fema.dhs.gov.
Sincerely, // signed//
Daisy Joseph Contracting Officer
PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM
CONTRACTOR INFORMATION
Contractor Name: _______________________ Street: ___________________________________________________________ City, State, Zip Code: _______________________________________________ Country: _________________________________________________________ Unique Entity ID (SAM): ____________________________________________
CONTRACT INFORMATION
Contract Number: ___________________________________________ Contract Title: ______________________________________________ Principal NAICS Code: _______________________________________ Assessment Type (Interim/Final): _______________________________ Contract Percent Complete: ____________________________________ Period of Performance Start Date: _______________________________ Estimate or Completion Date: __________________________________ Base and All Options Value: ___________________________________ Complexity of Work: _________________________________________ Type of Contract: ____________________________________________ Small Business Utilized: ______________________________________
CONTRACTOR POINT OF CONTACT INFORMATION
| Name: | _______________________ |
| Title: | _______________________ |
Phone Number: ______________________________________________ Email Address: ______________________________________________
RATING DEFINITIONS
Past Performance information requested pertain to the contractor’s record of past (within the past seven (7) years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that the information provided be as factual and accurate as possible.
The Agency is requesting that you use the following adjectival ratings in your response. Please provide comments to support the assigned rating. Additionally, use as many pages as needed for comments or any other information that is vital to contractor’s performance.
Exceptional: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.
Very Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Satisfactory: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions, or the corrective actions taken appear only marginally effective.
Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.
EVALUATION AREA, RATING, AND ASSESSING OFFICIAL COMMENTS
Quality of Work:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Quality
Schedule:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Schedule
Cost Control:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Cost Control
Management:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Management
Small Business Subcontracting:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Small Business Subcontracting
Regulation Compliance:
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Regulation Compliance
Other Areas (if applicable):
1.
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Other Area 1
2.
| Exceptional ☐ |
| Very Good ☐ |
| Satisfactory ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Other Area 2
3.
| Outstanding ☐ |
| Good ☐ |
| Acceptable ☐ |
| Marginal ☐ |
| Unacceptable ☐ |
Assessing Official Comments – Other Area 3
OTHER RELEVANT INFORMATION SUCH AS CORRECTIVE ACTIONS, ETCETERA
RECOMMENDATION
BASED ON YOUR KNOWLEDGE OF THIS CONTRACTOR’S ABILIT TO PERFORM IN ACCORDANCE WITH THIS CONTRACT OR ORDER MOST SIGNIFICANT REQUIREMENTS, I WOULD ☐, WOULD NOT ☐ RECOMMEND THEM FOR SIMILAR REQUIREMENT IN THE FUTURE.
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