Attachment G Past Performance Questionnaire.docx
DOCX document 35 KB Posted
- Solicitation number
- 60RRBH23R0011
- Issued by
-
Railroad Retirement Board
About this file
This document is a past performance questionnaire template for evaluating contractors for solicitation 60RRBH23R0011 to provide disability medical exams for the Railroad Retirement Board. The questionnaire asks evaluators to rate contractors on a scale of 1 to 5 in areas such as implementation of contract requirements, effectiveness of key personnel, quality of training and technical assistance, reporting features, management of contract requirements, timely completion of milestones, responsiveness, flexibility, communication, security compliance, and overall results achieved. Evaluators are also asked if they would award the contractor a similar contract in the future and if the evaluated contract was terminated or changed in value. The summary is intended to provide an overall assessment of the contractor's performance.
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PAST PERFORMANCE QUESTIONNAIRE
Name of Evaluator: ________________________________
Official Position: ________________________________
Name of Company: ________________________________
Company Address: ________________________________
Phone/Fax/Email: ________________________________
Period of Performance: ________________________________
| Contract No. (Indicate | |
| prime/subcontractor): | ________________________________ |
Contract Type: ________________________________
Contract Value: ________________________________
Please provide a thorough and complete description of the most recent services you have contracted for from the vendor.
Solicitation 60RRBH23R0011 Page 1 of 4 Attachment G – Past Performance Questionnaire
INSTRUCTIONS – For each item, circle the rating that best describes the contractor’s work on this project and provide any additional comments. For items not applicable to your project, please indicate N/A.
| 5= Excellent | No problems, issues, or delays in achieving contract requirements | ||
| 4= Good | Does not impact achievement of contract requirements | ||
| 3=Satisfactory | Requires minor agency resources to ensure achievement of contract requirements | ||
| 2=Marginal | Requires major agency resources to ensure achievement of contract requirements | ||
| 1= Unsatisfactory | Achievement of contract requirement is compromised | ||
| N/A= Not applicable | Does not apply |
(1) Overall implementation of the contract 5 4 3 2 1 N/A
Comments:
(2) Ability to pro-actively and aggressively perform 5 4 3 2 1 N/A contract requirements(s)
(3) Effectiveness and reliability of contractor's key personnel 5 4 3 2 1 N/A
(4) Quality and quantity of the training materials provided 5 4 3 2 1 N/A by the contractor
(5) Quality of the contractor’s on-going technical 5 4 3 2 1 N/A assistance and customer service
(6) Quality of the contractor’s reporting features and tools 5 4 3 2 1 N/A
(7) Overall ability to effectively manage contract 5 4 3 2 1 N/A
(8) Overall performance in planning, scheduling, and monitoring 5 4 3 2 1 N/A contract requirements
(9) Timely completion of major milestones 5 4 3 2 1 N/A
(10) Responsiveness/capability to respond to surge/short term 5 4 3 2 1 N/A requirements and aggressive timelines
(11) Displays initiative in meeting Government requirements 5 4 3 2 1 N/A and is responsive to the Government's needs
(12) Responsiveness and flexibility in responding to changes 5 4 3 2 1 N/A (both formal and informal)
(13) Provides prompt notification of problems 5 4 3 2 1 N/A
(14) Effectively assesses impacts of potential changes on other 5 4 3 2 1 N/A associated projects, tasks, and efforts
(15) Ability to solve contract performance problems without 5 4 3 2 1 N/A extensive guidance from Government personnel
(16) Overall management communication with your agency 5 4 3 2 1 N/A or organization
(17) Effectiveness in interfacing with Government personnel 5 4 3 2 1 N/A
(18) Quality of the contractor’s billing procedures, 5 4 3 2 1 N/A billing accuracy and resolution of billing discrepancies
(19) Ability to meet Agency’s security requirements 5 4 3 2 1 N/A
(20) For Federal responders, rate the ability of the contractor’s 5 4 3 2 1 N/A products to meet 508 regulatory and compliance guidelines
Comments:
Based on this contractor’s overall performance, would you award this contractor a similar contract?
Yes [ ]No [ ] If “no’, please explain:
Has this contract been partially or completely terminated?
Yes [ ] No [ ] If “yes’, please explain:
Were there any changes in contract dollar value throughout the life of the contract?
Yes [ ] No [ ] If “yes”, please explain:
In summary, please give your overall assessment of this contractor and the actual results achieved as a result of this contractor’s performance.
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