Attachment F - Past Perf. Quest and Letter (July 30).docx

HRSA Solicitation: 75R60220R00023

Section J ATTACHMENT F – PAST PERFORMANCE QUESTIONNAIRE LETTER

Date: July 30, 2020

Dear Client:

We are currently responding to the Health Resources and Services Administration (HRSA) Solicitation No. RFP# entitled, 75R60220R00023 “Support the Advisory Committee on Heritable Disorders”. The Government is placing increased emphasis in its acquisition process on past performance as an evaluation factor and is requiring that clients of firms responding to HRSA solicitations be identified and their participation in the evaluation process be requested.

Therefore, enclosed is a past performance questionnaire for your completion. We are requesting that you complete the questionnaire and send it directly to HRSA at the following address:

Email: Bjohn@hrsa.gov

Since this information will be used as one of the evaluation factors for contract award, we are requesting that you complete this questionnaire and return it to the HRSA Contract Specialist at the above email address no later than August 21, 2020 at 17:00 PM (EST).

We thank you for your prompt response in this matter.

Sincerely, (To be signed by Offeror)

PAST PERFORMANCE INFORMATION SURVEY QUESTIONNAIRE

FOR: ________________________________________________________________________

Name of Company

PLEASE RETURN COMPLETED SURVEY TO:

Email: Bjohn@hrsa.gov

PLEASE FILL IN THE FOLLOWING:

Your Name: ____________________________ Your Agency:________________________ Address:___________________________________________________________________ Phone Number:_________________________ Fax :________________________________ Signature of Person Completing Survey:___________________________________________ Contract Number/Solicitation Number: ____________________________________________

YOUR ROLE IN THIS CONTRACT (circle one)

Contracting Officer’s Representative (COR) Contracting Officer Contract Specialist

Approximate Percentage of Work Competed by Subcontractors: ______ %

General Description or work or Title of Contract: _____________________________________________

RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible.

Standard Contractor Performance Report

Contractor Name:

Supplies or Services:

Ratings

Summarize contractor performance and check the number which corresponds to the rating for each rating category (See attached Rating Guidelines).

Quality of Product or Service Unsatisfactory Poor Fair Good Excellent _Outstanding

Government Comments for Quality of Product or Service:

Cost Control (Rating and Comments for Cost Control are not required if contract type is Fixed-Price) Unsatisfactory Poor Fair Good Excellent Outstanding

Government Comments for Cost Control:

Timeliness of Performance Unsatisfactory Poor Fair Good Excellent Outstanding

Government Comments for Timeliness of Performance:

Business Relations Unsatisfactory Poor Fair Good Excellent Outstanding

Government Comments for Business Relations:

Additional Info

Subcontracts

Are subcontracts involved? __Yes __No (Check one) Comment on subcontracts (2000 characters maximum):

Customer Satisfaction

Is/was the contractor committed to customer satisfaction? _Yes _No (Check one)

Would you recommend the selection of this firm again? _Yes _No (Check one) –

Comments on Customer Satisfaction:

Admin Info

Project Officer/COR Name:

Phone:

Fax:

E-mail Address:

Contracting Officer:

Name:

Phone:

Fax:

E-mail Address:

Rating Guidelines

Quality of Product or Service

Cost Control

Timeliness of Performance

Business Relations