B08_Attachment_3_PAST_PERFORMANCE_QUESTIONNAIRE.docx

PAST PERFORMANCE QUESTIONNAIRE

U.S. Fish and Wildlife Service

Contractor Being Evaluated: ___________________________

Submitting Proposal as Prime Contractor [ ] Subcontract [ ]

If submitting as Subcontractor, your prime contract is_____________________

I. Background

The purpose of this questionnaire is to obtain past performance information relative to contracts that have previously been completed or are currently being performed by the contract identified above. The company is a potential source for performing a Firm Fixed Price Contract.

II. Instructions

Please complete the questionnaire based on the following guidance:

A. Handwritten responses are sufficient.

B. Indicate, based on the description below, the contractor’s performance on the identified program in the assessment area. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels.

CODE PERFORMANCE LEVEL

E EXCEPTIONAL – The contractor’s performance meets the contractual requirements and exceed many requirements.

VG VERY GOOD – The contractor’s performance meets contractual requirements and exceeds some requirements.

S SATISFACTORY – No problems exist or only minor problems for which solutions are in hand.

M MARGINAL – Problems exist for which there is doubt whether the identified solution is adequate, but the problem appears to be within the contractor’s ability to solve.

U UNSATISFACTORY – Serious problems exist which may be outside the contractor’s ability to solve. The contractor is in danger of being able to satisfy contractual requirements and timely recovery is not likely.

N NOT APPLICABLE – Unable to provide a score.

C. Circle the word or phrase corresponding to your rating. Please provide comments for all questions in which an Unsatisfactory, Marginal or Satisfactory rating is given as appropriate for all other answers. Space for your comments is provided in each area. If more space is needed, attach additional sheets to the end of the questionnaire and reference the respective questions.

D. You are urged to supplement your own knowledge to the contractor’s performance with the judgment of others in your organization. In addition to completing the attached questionnaire for the program, we solicit your comments on other similar programs for which your office has contact with the contractor.

E. PLEASE FAX OR EMAIL YOUR COMPLETED QUESTIONNAIRE TO:

YOUR ASSISTANCE IN EVALUATING THE CONTRACTOR’S PAST PERFORMANCE IS APPRECIATED. OUR GOAL IS TO SELECT THE BEST VALUE TO THE GOVERNMENT. YOUR PAST PERFORMANCE EVALUATION IS A CONSIDERATION IN DETERMINING THE BEST VALUE.

III. Contract Referenced

Evaluator, please complete:

A. Contractor being evaluated: _______________________________ B. Contract Number: _______________________________________ C. Estimated Contract Amount: ______________________________ D. Period of Performance: __________________________________ E. Describe Product Acquired: _______________________________ F. Contract Type: _________________________________________

IV. Past Performance Evaluation

1. Overall Customer Satisfaction; e.g, rapport with customer, information sharing, reporting procedures, and technology used, and meeting design in accordance with the Statement of Work or Performance Work Statement?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Comments:___________________________________________________________________________________________________________________________________________________________________

2. How well the contractor’s management-controlled funding cost?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Comments:___________________________________________________________________________________________________________________________________________________________________

3. What is your assessment of the Contractor’s timeliness/meeting period of performance (POP)?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Comments:___________________________________________________________________________________________________________________________________________________________________

Put an X next to the most applicable answer:

Knowing what I know about this contractor:

___ I would enter another contract with this contractor.

___ I might enter another contract with this contractor.

___ I would not enter another contract with this contractor.

V. Respondent Information:

The following information will assist in the analysis of the data and will be kept confidential.

A. Name of Evaluator: ______________________ B. Address: _______________________________ C. Phone/Fax: _____________________________ D. Position Title: __________________________ E. Date Questionnaire Completed: ____________