Attachment No. 12 NIH Customer Perf.pdf

ATTACHMENT No. 12

PAST PERFORMANCE INFORMATION

NATIONAL INSTITUTES OF HEALTH CUSTOMER SURVEY OF CONTRACTOR PERFORMANCE

Please complete the following questionnaire and return via regular mail or fax to the attention of:

___________________________________________________by (Date)_______________ (Name)

(Address)

(Fax Number)

This survey pertains to: __________________________________________________________

Department/Component: _________________________________________________________

Contract Number: _________________________ Date of Survey: ____________________

Name of Person Completing Survey: ________________________________________________

Signature of Person Completing Survey: _____________________________________________

Your Company/Agency: ___________________________________________________________

Your Role in this Contract (circle one): Contracting Officer Contract Specialist Project Officer Other ________________________

Contract Value (including options): $ ________________________________________________

Period of Performance (including option periods): _____________________________________

Type of Contract: __________________________________________________________________

Approximate percentage of work being performed (or completed) by subcontractor(s):_________%

Information on subcontractor(s) (where more than _______ % of work was completed by the subcontractor) :

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

General description of products / services required under the 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. Commentary to support rating may be noted on page 5.

Assign each area a rating of 0 (unsatisfactory) , 1 (Poor) , 2 (Fair) , 3 ( Good) , 4 (Excellent) , or 5 (Outstanding) . Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the contractor to make a determination on any of the performance criteria below, please circle “N/A” (not applicable / no opinion).

QUALITY OF SERVICE

1. Compliance with contract requirements 0 1 2 3 4 5 N/A

2. Accuracy of reports 0 1 2 3 4 5 N/A

3. Effectiveness of personnel 0 1 2 3 4 5 N/A

4. Technical Excellence 0 1 2 3 4 5 N/A

COST CONTROL

1. Record of forecasting and controlling target costs 0 1 2 3 4 5 N/A

2. Current, accurate and complete billings 0 1 2 3 4 5 N/A

3. Relationship of negotiated costs to actuals 0 1 2 3 4 5 N/A

4. Cost efficienciese

TIMELINESS OF PERFORMANCE

1. Met interim milestones 0 1 2 3 4 5 N/A

2. Reliability 0 1 2 3 4 5 N/A

3. Responsive to technical directions 0 1 2 3 4 5 N/A

4. Completed on time including wrap-up and contract administration 0 1 2 3 4 5 N/A

5. Met delivery schedules 0 1 2 3 4 5 N/A

6. Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS

1. Effective management, including management of subcontracts 0 1 2 3 4 5 N/A

2. Reasonable/cooperative behavior 0 1 2 3 4 5 N/A

3. Responsive to contract requirements 0 1 2 3 4 5 N/A

4. Notification of problems 0 1 2 3 4 5 N/A

5. Flexibility 0 1 2 3 4 5 N/A

6. Pro-active vs reactive

SMALL BUSINESS AND SMALL DISADVANTAGED BUSINESS GOALS

The contractor met the goals set forth in its Subcontracting Plan. (See FAR 19.7 and FAR 15.305(a)(2)(v)) Yes No (circle one)

Comments: (optional) _____________________________________________________

The contractor met Small Disadvantaged Business Participation goals. (See 15.305(a)(2)(v) and FAR 19.1202)

Comments: (optional) _____________________________________________________

CUSTOMER SATISFACTION

1. The Contractor is committed to customer satisfaction.

Yes No (circle one)

2. Would you recommend selection of this firm again?

ADDITIONAL COMMENTS

QUALITY OF PRODUCT

OR SERVICE

COST CONTROL TIMELINESS OF

PERFORMANCE

BUSINESS

RELATIONS

0-

UNSATISFACTORY

Contractor is not in compliance and is jeopardizing achievement of contract objectives

Contractor is unable to manage costs effectively

Contractor delays are jeopardizing performance of contract objectives

Response to inquiries, technical/ service/ administrative issues is not effective 1-Poor Major problems have been encountered Contractor is having major difficulty in managing costs effectively

Contractor is having major difficulty meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is marginally effective

2-Fair Some problems have been encountered

Contractor is having some problems in managing costs effectively

Contractor is having some problems meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is somewhat effective

3-Good Minor inefficiencies/ errors have been identified Contractor is usually effective in managing costs

Contractor is usually effective in meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is usually effective

4-Excellent Contractor is in compliance with contract requirements and/ or delivers quality products / services

Contractor is effective in managing costs and submits current, accurate, and complete billings

Contractor is effective in meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is effective

5-Outstanding: The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as “Excellent.”

EXAMPLE, REQUEST FOR PAST PERFORMANCE INFORMATION

Date:

Dear Client:

We are currently responding to the DHHS/NIH/NINDS RFP-10-01 entitled: “Medicinal Chemistry for Neurotherapeutics Program (MCNP).” The Government is placing increased emphasis in their procurements on past performance as a source selection factor and is requiring that clients of firms responding to NINDS 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 return it to the undersigned by _______________, as this information must be submitted along with our business proposal.

We thank you for your prompt response in this matter.

Sincerely, (To be signed by offeror)

Attachment