B08 - RFQ_Exhibit 3_Past Performance Survey.docx

PAST PERFORMANCE SURVEY (Exhibit 3)

The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

RATING DEFINITIONS

The following ratings and definitions are to be used for completion of this survey:

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

REFERENCED CONTRACT INFORMATION

Referenced Organization

Contract Title

Contract Number

Contract Type

Period of Performance

Award Value

Scope of Work

AREAS OF PERFORMANCE EVALUATION

A. Quality of Service.

Did the contractor conform to the specifications of your requirement and meet your needs? (Y/N) Are the deliverables of a good quality? (Y/N)

Quality of Service Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

B. Effectiveness of Project Management.

Were subcontractors and Key Personnel managed effectively to meet your requirement? (Y/N) Were project oversight, planning, and staffing successful in meeting your needs? (Y/N)

Effectiveness of Project Management Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

C. Schedule.

Were performance/deliverables on time? (Y/N)

Schedule Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

D. Cost Control:

Did the contractor operate within the budget proposed without significant cost under/over-runs? (Y/N)

Cost Control Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

E. Business Relations.

Does the staff operate professionally? (Y/N) Is communication efficient and effective? (Y/N)

Business Relations Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

F. Customer Satisfaction:

Were any complaints filed within your organization against this contractor? (Y/N) Would you recommend this vendor to others, and if so, why? (Y/N)

Customer Satisfaction Rating:

___Acceptable ___Marginal ___Unsatisfactory

Additional Comments:

G. Overall Past Performance comments for this reference:

RESPONDENT IDENTIFICATION

Name:

Title:

Organization:

Address:

Telephone:

Email: