Attachment D Past Performance Questionnaire.pdf

RFP 70FA6024R00000012 ATTACHMENT C

DHS/FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA)

PAST PERFORMANCE QUESTIONNAIRE

PROJECT TITLE: HAZARD MITIGATION TECHNICAL ASSISTANCE PROGRAM (HMTAP)

SUPPORT SERVICES

Project Description: This requirement will support the FEMA/HMTAP non-architectural and non-engineering (non-A&E) technical assistance, including but not limited to; program application review/feasibility, research, analysis, and document development services in support of FEMA’s pre-disaster, disaster, and post-disaster mitigation and environmental compliance requirements.

The overarching objectives for the HMTAP Support Services are:

• Assistance to Resilience Grant Programs (Task 1);

• Environmental and biological assessments (Task 2);

• Non-Architectural and Engineering (non-A&E) post-event assessments (Task 3);

• Non-A&E Technical assistance (Task 4);

• Technical assistance to policies (Task 5);

• Benefit-Cost analysis (BCA) helpline assistance (Task 6); and

• Technical advisement/support (Task 7).

Offerors were asked to provide information on contracts similar in scope, size and complexity to the present requirement on which they had performed in the past. An offeror submitted you as a reference for past performance. We need your opinion on how well the contractor performed on this contract. Please fill out this past performance reference form and return via email to directly the DHS/FEMA Contract Specialist, Amanda Long via email at amanda.long@fema.dhs.gov and Contracting Officer, Glen Seipp at glen.seipp@fema.dhs.gov.

Please note your comments will be used to form the basis for evaluation of this offeror. Thank you in advance for your assistance.

CERTIFICATION

By law, the Government will not disclose the names of individuals providing reference information during discussions with the contractor identified in Block 1 below.

Page 1 of 4 Pages mailto:amanda.long@fema.dhs.gov mailto:glen.seipp@fema.dhs.gov

PAST PERFORMANCE REFERENCE FORM

PROJECT TITLE: HMTAP SUPPORT SERVICES

Block 1. Contractor/Reference | Block 2. Contract Name/Identifier (being rated) |

I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS QUESTIONNAIRE IS

ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Evaluator’s Printed Name Title

Evaluator’s Mailing Address (Agency, Bldg/Room, Street, City, State, and Zip)

Evaluator’s Signature Date Phone Email

INSTRUCTIONS

Two forms are provided to document your opinion: 1) Performance Rating Form; and 2) Supplemental Comment Form. Please fill out each form in accordance with the instructions provided on each. Please use the following standards in arriving at your rating:

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 were 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.

Other - The element is not applicable, no data has been obtained, or additional comments are provided.

Page 2 of 4 Pages

Performance Rating Form

Performance Element Exceptional Very Good Satisfactory Marginal Unsatisfactory Other

1. TECHINCAL QUALITY OF

SERVICES: The contractor provided high quality of service and performed successfully.

2. COST CONTROL AND EFFECTIVE

AND EFFICIENT USE OF RESOURCES:

The contractor deployed, in a timely manner, the proper amount and type of personnel, facilities and other resources to support the project. Use of subcontractors was appropriate in supporting the project. The contractor successfully planned and proposed realistic costs and monitored performance, and consistently operated at or below budget.

3. SCHEDULE/TIMELINESS OF

PERFORMANCE: The contractor planned and proposed realistic schedules, successfully monitored performance, and completed work on time.

4. BUSINESS RELATIONS, CUSTOMER

SATISFACTION: The contractor exhibited a commitment to customer satisfaction and achieved customer satisfaction. The contractor exhibited reasonable and cooperative behavior in response to client changes, criticism/rejection of contract deliverables and in detecting and correcting errors, poor performance, and other problems.

YES NO

5. Given the choice would you do business with this contractor again?

Page 3 of 4 Pages

Supplemental Comment Form

Please provide any additional comments regarding your performance element ratings in the appropriate spaces below. Please add additional pages as necessary.

Performance Element #1, Technical Quality of Services:

Performance Element #2, Cost Control and Effective and Efficient Use of Resources:

Performance Element #3, Schedule/Timeliness of Performance:

Performance Element #4, Business Relations, Customer Satisfaction

Page 4 of 4 Pages