Attachment J-12 Past Performance Questionnaire.pdf
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- Attached to
- Residential Drug Treatment Services (FY 2024)
- Solicitation number
- 9594CS24R0022
About this file
This document contains a past performance questionnaire for a federal contract solicitation. The solicitation is for residential drug treatment services to be provided at a contractor's facility located within 30 miles of Washington, D.C. The services will stabilize substance use disorders, enhance supervision compliance, and return offenders to the community free from illicit substance use. The normal placement length is up to 30 days including a 30-day restricted movement period, but may be extended up to 30 additional days with approval. The questionnaire is to be completed by a reference for the contractor's past performance on a similar contract and addresses factors such as schedule, management, quality, and business relations performance ratings and narratives. It is due from contractors by April 15, 2024 as part of a proposal submission to the Court Service and Offender Supervision Agency.
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Attachment J-12 Past Performance Questionnaire
Past Performance Questionnaire
PLEASE EMAIL THE COMPLETED QUESTIONNAIRE NO LATER THAN 11:00 AM (local Washington, DC time), April 15, 2024, to Andrea.albanese@csosa.gov and Valerie.wallace@csosa.gov.
1. The Contractor in A below has identified the Questionnaire Respondent as someone for whom the Contractor provided a service similar to the service requirement in paragraph 2.
2. The Contractor is submitting a proposal to the Court Service and Offender Supervision Agency (CSOSA) to provide the following: Residential Drug Treatment Services.
3. This Questionnaire should be completed by the individual most knowledgeable of the
Contractor’s day-to-day operations and overall condition of the supplies/services provided under the referenced contract. However, that individual is encouraged to supplement their knowledge of the Contractor’s performance with the judgement and observations of others within their organization, as applicable.
4. Handwritten responses are sufficient, however, please ensure they are legible.
5. Please provide explanatory narratives for as many responses as possible. These narratives need not be lengthy, just descriptive. Space for narrative comments is included on the last page of the questionnaire. If more space is required, additional pages may be added to this questionnaire.
Please clearly identify which evaluation factor a narrative applies to.
6. As this questionnaire relates to an ongoing source selection for “Residential Drug Treatment
Services”, we request that all information provided in this questionnaire be safeguarded against unauthorized disclosure.
A. CONTRACTOR INFORMATION: (Contractor requesting reference complete Section A)
Contractor Name: _________________________________________________________________
Reference Contract Number: ________________________________________________________
Project Title or Brief Description of the Supplies/Services Provided by the Contractor under the
Reference Contract: ___________________________________________________________________
Note: If the Contractor holds, or has held, other contracts with your agency/organization in the last 3 years, please complete a separate questionnaire for each of those contracts.
B. QUESTIONNAIRE RESPONDENT INFORMATION:
Respondent Name: ___________________________ Title: __________________________________
Respondent’s Phone #: ________________________ Email:
Respondent’s Company Name: __________________________________________________________
Company Address: ____________________________________________________________________
CONTRACT PERFORMANCE INFORMATION:
1. What was the period of performance start and end dates for the Reference Contract:
From: _______________________ To: ___________________________
2. What was the total value of the Reference Contract? __________________________
3. In what capacity did the Contractor provide supplies/services to under the Reference
Contract? Prime Contractor ______ Subcontractor ______ Key Person ________
4. Please use the following Performance Scale to rate the Contractor’s performance on the
Reference Contract, where a 6 is Exceptional and a 1 is Neutral. Please place the number that corresponds with the level of performance that you experienced/observed in the box on the right side of the performance criteria.
5. Please provide a narrative explanation for any ratings of 1, 2 or 3.
Performance Scale
6 Exceptional
Performance meets contractual requirements with many exceeded to the benefit of the Government or client (if a non-Government contract). The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.
5 Good
Performance meets contractual requirements with some exceeded to the benefit of the Government or client (if a non-Government contract). The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.
4 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 were satisfactory.
3 Marginal
Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yete identified corrective actions or the contractor's proposed actions appearonly marginally effective or were not satisfactory.
2 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 for which the contractor's corrective actions appear, or were ineffective.
1 Neutral Performance was not observed or not applicable to the current effort being reported against
SCHEDULE RATING
1 Contractor’s responsiveness/timeliness in providing the required services.
2 Contractor’s responsiveness/timeliness to administrative functions of the contract.
3 Contractor’s responsiveness/timeliness in responding to questions or correspondence.
4 Contractor’s compliance with contract terms and conditions.
5 Were any contract concessions, changes, or terminations made due to the contractor’s failure to accurately plan?
MANAGEMENT OF KEY PERSONNEL RATING
6 Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period?
7 Contractor's preparation & training of personnel 8 Contractor's ability to effectively manage subordinates.
QUALITY OF SERVICES RATING
9 Provided effective quality control and/or inspection procedures to meet contract requirements.
10 Followed the approved quality control plan.
11 Corrected deficiencies in a timely manner and pursuant to the quality control procedures.
12 Provided timely resolution of contract discrepancies.
13 Suggested alternative approaches to problem solution.
14 Displayed initiative to identify and solve problems as they occurred.
15 Developed realistic progress schedules.
16 Met established project schedules.
17 Demonstrated ability to assimilate & accommodate changes in contractual requirements and/or priorities.
18 Exhibited knowledge of, and compliance with, Government (or other) rules and regulations.
19 Demonstration of technical expertise in providing all contracted services.
20 Possessed and utilized the tools and equipment necessary to adequately provide the required services.
21 Accomplishment in meeting the quality standards specified for:
a. Technical Performance
b. Administrative Performance
c. Safety & Health
22 Did the Contractor ever fail to effectively control the quality of services provided?
If Yes, please explain in the Narrative Remarks section below.
23 Was a Contract Discrepancy Report, or equivalent, ever issued? If Yes, please explain in the Narrative Remarks section below.
24 Was a Cure Notice or Show Cause Letter ever issued? If Yes, please explain in the Narrative Remarks section below.
25 Were there any disputes/claims relative to the contract? If Yes, please explain in the Narrative Remarks section below.
Has Contractor demonstrated the ability to correct any of the problems identified in 22, 23, 24 or 25 above? If Yes, please explain in the Narrative Remarks section below.
27 Has this Contractor ever been terminated for default? If Yes, please explain in the Narrative Remarks section below.
28 Has an election ever been made to not exercise an option due to the Contractor's poor performance? If Yes, please explain in the Narrative Remarks section below.
BUSINESS RELATIONS RATING
29 Contractor's management of subcontractors.
30 Have there been any labor disputes? If Yes, please explain in the Narrative Remarks section below.
31 Have there been any violations of Public Law, especially the Service Contract Act?
If Yes, please explain in the Narrative Remarks section below.
32 Contractor's ability/willingness to consistently provide prompt and courteous service.
33 Contractor's ability/willingness to promptly and courteously resolve customer complaints.
34 Contractor's overall commitment to customer satisfaction.
35 Contractor's overall cooperation relative to the contract.
36 How would you rate the integration and coordination of all activity needed to perform this contract?
37 How would you rate the Contractor's overall performance?
38 Would you award another contract to this Contractor? If Not, please explain in the Narrative Remarks section below.
Narrative Remarks: (Please include the corresponding question # in the remark):
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