Attachment D - Past Performance Questionnaire.pdf

Attachment D

Past Performance Questionnaire From: DeAndre Rawlings, Contract Specialist TSA, Screening Partnership Program

PAST PERFORMANCE QUESTIONNAIRE

Contract:

Please submit completed past performance questionnaire by _____ to Contract Specialist: DeAndre Rawlings, deandre.rawlings@tsa.dhs.gov

(1) Name of Contractor questionnaire is being completed for:

(2) Contract Number and Order Number (if applicable):

(3) Role Contractor played in Contract listed in ☐ Prime ☐ Subcontractor ☐ Other

(4) Contract Type:

(5) Contract Value (including all Options):

(6) Name of Respondent:

(7) Position/Title:

(8) Agency:

(9) Phone No. and Email:

(10) Length of involvement in program/contract:

(11) Date questionnaire was completed:

mailto:deandre.rawlings@tsa.dhs.gov

RATING SCALE: Please use the following ratings to answer the questions on page 4.

Rating Definition

Exceptional Performance meets contractual requirements and exceeds many requirements to the benefit of the Government. The contractual performance of the element being assessed 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 requirements to the benefit of the Government. The contractual performance of the element being assessed 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 being assessed contains some minor problems for which corrective actions taken by the Contractor appear to be or were satisfactory.

Marginal

Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the Contractor has not yet identified corrective actions or the Contractor’s corrective actions appear only marginally effective or were not fully implemented.

Unsatisfactory

Performance does not meet most contractual requirements and corrections are not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the Contractor’s corrective actions appear to be or were ineffective.

N/A

(Not applicable) should be used if the ratings are not going to be applied to a particular area for evaluation

NOTE: For statements indicating less than “Satisfactory”, please provide a brief explanation in the comments section of the survey.

CONTRACTOR PAST PERFORMANCE EVALUATION SURVEY FOR

SERVICES

E xc ep tio na l

V er y G oo d

Sa tis fa ct or y

M ar gi na l

U ns at is fa ct or y

N /A

A.) QUALITY OF SERVICE:

(1) How successful was the Contractor in providing a service that conformed to contract requirements and specifications?

(2) How successful was the Contractor in submitting accurate reports?

(3) How would you rate the Contractor’s ability to quickly respond to frequently changing requirements?

(4) How responsive to technical and/or contractual direction was the Contractor?

OVERALL RATING

B.) SCHEDULE:

(1) How successful was the Contractor in performing tasks/services under this effort in a timely manner and according to the agreed upon schedule?

(2) How successful was the Contractor in submitting deliverables in accordance with contract requirements?

(3) If the schedule slipped due to the Contractor’s fault or negligence, how successful was the corrective action if one was taken?

C.) COST:

(1) How well did the Contractor keep within the total estimated cost (what is the relationship of the negotiated costs and budgeted costs to actuals)

(2) How successful was the Contractor at keeping their billing current, accurate and complete?

CONTRACTOR PAST PERFORMANCE EVALUATION SURVEY FOR

SERVICES

E xc ep tio na l

V er y G oo d

Sa tis fa ct or y

M ar gi na l

U ns at is fa ct or y

N /A

D.) MANAGEMENT:

(1) How well did the Contractor demonstrate effective management over the effort performed?

(2) How well did the Contractor maintain an open line of communication so that the customer was apprised of technical, cost, and schedule issues and risks?

(3) How well did the Contractor exhibit reasonable and cooperative behavior during performance?

(4) How adequate was the Contractor’s accounting, billing, and estimating systems?

E.) SMALL BUSINESS SUBCONTRACTING: (If applicable)

(1) Was the Contractor compliant with all terms and conditions in the contract/order relating to Small Business participation goals and if so how did they perform?

(2) How well did the Contractor take efforts to ensure early identification of subcontract problems and the timely application of corporate resources to preclude subcontract problems from impacting overall prime contractor performance?

(3) How did the Contractor address the timeliness of awards to Subcontractors and management of Subcontractors, including subcontract costs?

F.) REGULATORY COMPLIANCE:

(1) Has the Contractor complied with all contract clause requirements?

(2) Has the Contractor complied with the reporting requirements of the contract?

COMMENTS: