B08_SOL_-_Attachment_4_-_Past_Performance_Questionnaire.docx
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- HHS ACL IDIQ Federal contract opportunity
- Solicitation number
- 140D0423R0055
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Attachment 4 – Past Performance Questionnaire Solicitation 140D0423R0055
WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE IAW FAR 3.104
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor: ______________________________________
B. Agency/Client: ___________________________________
C. Contract/Project Title: _______________________________________
D. Contract Number: ______________________________
E. Contract Type: _________________________________________________________
F. Period of Performance: __________________________________________________
G. Contract Value:
Initial: ___________ Final: ___________
H. Offeror role (Prime or Subcontractor)
I. Government Point of Contact:
Name: ______________________________________ Email Address: _______________________________ Telephone Number: ____________________________
J. Description of service provided:
SECTION 2: EVALUATION
Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:
| CODE |
| PERFORMANCE LEVEL |
| O |
| OUTSTANDING - The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example to others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as “Excellent”. |
| E |
| EXCELLENT – The contractor has substantially exceeded the contract performance requirements. |
| G |
| GOOD – There are no, or very minimal issues and the contractor has met the contract requirements. |
| F |
| FAIR – Overall compliance requires minor agency resources to ensure achievement of contract requirements. |
| P |
| POOR – Overall compliance requires significant agency resources to ensure achievement of contract requirements. |
| U |
| UNSATISFACTORY – Non-conformances are jeopardizing the achievement of contract requirements, despite use of agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements. |
| N |
| NOT APPLICABLE - Unable to provide a score |
| Quality of Product or Service |
| O |
| E |
| G |
| F |
| P |
| U |
| N |
Ability to understand/comply with customer objectives and technical requirements
Effectiveness of assigned personnel in terms of the appropriate mix of education and experience to accomplish the requirement.
Adequacy/effectiveness of quality control program
Quality/effectiveness of sub-contracted efforts
| Program Management, Timeliness of Performance & Business Relations |
| O |
| E |
| G |
| F |
| P |
| U |
| N |
Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)
Timeliness/effectiveness of contract problem resolution without extensive customer guidance
Ability to successfully respond to emergency and/or surge situations
Effectiveness of material management (including Government Furnished Property or Material)
Contractor proposed alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the customer
Contractor implemented responsive/flexible processes to improve quality and timeliness of support.
Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)
| Transition/Phase-in & Employee Retention/Attraction |
| O |
| E |
| G |
| F |
| P |
| U |
| N |
Contractor ability to smoothly transition resources and personnel.
Contractor effectiveness on maintaining continuity of mission support while transitioning/phasing in resources and personnel to support other efforts.
Ability to hire/apply a qualified workforce to this effort.
Ability to retain a qualified workforce on this effort.
| Cost Control |
| O |
| E |
| G |
| F |
| P |
| U |
| N |
Accuracy in forecasting contract costs
Ability to meet forecasted costs and perform within contract costs
Ability to alert Government of unforeseen costs before they occur
Sufficiency and timeliness of cost reporting
Government Contracts Only: has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?
| Yes___ | Default___ | Convenience___ | Pending Terminations___ |
| No ___ |
If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).
SECTION 3: NARRATIVE SUMMARY
What were the contractor’s greatest strengths in the performance of the contract?
What were the contractor’s greatest weaknesses in the performance of the contract?
Would you hire this contractor in the future to perform one of your critical and demanding programs?
Please provide any additional comments concerning this contractor’s performance, as desired.
Evaluator’s Signature Date
Thank you for your prompt response and assistance!
Please return this completed questionnaire to the offeror that has submitted for evaluation, they will provide with their proposal submission.
If uncomfortable with providing directly to the contractor, please submit a copy to:
Stephanie McCullough, stephanie_mccullough@ibc.doi.gov
And
Stephanie Gibbs, stephanie_gibbs@ibc.doi.gov
File details come from the government source that posted it. Updated .