Attachment J-8 Past Performance Questionnaire 75F40123R00003.pdf

Attachment J-8

Past Performance Questionnaire

Dear Sir or Madam:

The U.S. Food and Drug Administration (FDA), has a requirement to procure “Comprehensive Hazardous Waste Management Services” for the Collection, Transportation and Disposal of Chemical, Radioactive and Radioactive Waste Generated by the FDA, Nationwide, including Puerto Rico.

To accomplish this goal, the FDA requires a Contractor to provide, either directly or through qualified sub- Contractors, all aspects of a comprehensive, cradle to grave hazardous chemical, radiological, radioactive and medical pathological waste/ disposal, dangerous goods shipping and inventory management service generated by the FDA research laboratory activities in FDA facilities nationwide, including Puerto Rico, as defined in the solicitation. Services shall be required on an ongoing basis as set forth in a single IDIQ and issued Task Orders.

FDA is conducting a performance confidence assessment in anticipation of a possible contract award. An Offeror interested in proposing on this work has identified you as a Point of Contact (POC) on a past or present contract which the Offeror deems relevant to this effort. The Government is therefore, requesting your assistance in completing the attached Past Performance Assessment Questionnaire, so that FDA may evaluate the Offeror under the Factor of Past Performance. The Questionnaire has been developed for electronic completion. Please provide your comments regarding the overall assessment of the Offeror’s performance on the contract identified and any additional information that your organization deems relevant to our evaluation team. It is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators.

Please complete and submit the Questionnaire via e-mail to the Contracting Officer at :

Monifa.Coleman@fda.hhs.gov . If you have any questions relative to the enclosed Questionnaire, please contact me.

Thank you in advance for your assistance.

Sincerely, Monifa Coleman Contracting Officer (CO) Monifa.Coleman@fda.hhs.gov mailto:Monifa.Coleman@fda.hhs.gov

Past Performance Information Form

Please provide your responses. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter.

Adjectival Rating Definitions:

Substantial Confidence. Present/past performance effort involved essentially the same scope and magnitude of effort and complexities this solicitation requires.

Satisfactory Confidence. Present/past performance effort involved similar scope and magnitude of effort and complexities this solicitation requires.

Limited Confidence. Present/past performance effort involved little or none of the scope and magnitude off effort and complexities this solicitation requires.

No Confidence. Present/past performance effort involved little or none of the scope and magnitude of effort and complexities this solicitation requires.

PART I. (To be completed by the Offeror)

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

Substantial Confidence (Explanation must be provided in Comments field below) Satisfactory Confidence Limited Confidence (Explanation must be provided in Comments field below) No Confidence (Explanation must be provided in Comments field below)

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Comments:

Limited Confidence (Explanation must be provided in Comments field below) No Confidence (Explanation must be provided in Comments field below)

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

Signature:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Official identified in the cover letter.

Thank you for your assistance.

F. General Comments. Provide any other relevant performance information.

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables.

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

G. Other Information Sources. Please provide the following information:

H. Respondent Identification. Please provide the following information: