ATTACHMENT J.2 Past Performance Reference Questionnaire .docx

PAST PERFORMANCE REFERENCE QUESTIONNAIRE

USAID/Indonesia is seeking relevant past performance information for a USAID Health Technical Assistant II (USAID Bantu II) Solicitation No. 72049723R00002, for which the selected offeror will provide technical assistance in support of the goals and objectives of USAID/Indonesia.

Please provide some brief feedback and select one of the ratings of the sub-criteria below. A table of the definitions for each of the ratings is included in the table provided on the last page of this letter.

Please respond by May 19, 2023, by sending this feedback directly to USAID/Indonesia at proposals-indonesia@usaid.gov . Please label the Subject Line of the email as

“ [Name of Offeror] - 72049723R000002 – USAID Bantu II - Past Performance Reference

If you have any additional questions or comments, please feel free to email the Point of Contact: Ms. Yulian Christanti, A&A Specialist, via email at proposals-indonesia@usaid.gov.

Thanks for your time in responding. Your feedback is greatly appreciated in assisting the Technical Evaluation Committee in its evaluation process.

A. Reference Information

Name of Individual Providing Reference

Date Reference Provided

Reference’s Employer

Contract Name

E-mail

Phone

Contract Begin Date

Contract End Date

Contact’s Role or Knowledge of Contract

B. Performance Information (See attachment for rating definitions)

1. Please rate your satisfaction with the quality of product or service, including consistency in meeting project/service goals and targets.

___Exceptional ___Very Good ___ Satisfactory ___ Marginal ___ Unsatisfactory

Comments:

2. Please rate the Contractor’s ability to control costs, including forecasting costs as well as accuracy in financial reporting and rating. (Not applicable for firm-fixed-price or fixed-price with economic price adjustment arrangements)

3. Please rate the timeliness of contract performance to include schedule, timeliness against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements and rating.

4. Please rate the quality of management or business relations, addressing the history of professional behavior and overall business-like concern for the interests of the customer, including the contractor’s history of reasonable and cooperative behavior.

5. For prime offerors who are not small business concerns, please rate their utilization of small business concerns as subcontractors, including efforts in achieving small business participation goals and rating.

Rating Definitions

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated 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 to the Government’s benefit. The contractual performance of the element or sub-element being evaluated 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 or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

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(s) for which the contractor’s corrective actions appear or were ineffective.