Attachment_7_-_Past_Performance_Questionnaires.pdf

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Attached to
Dental Insurance Program Federal contract opportunity
Solicitation number
CC14HQR0010
Issued by
Department of the Treasury Office of the Comptroller of the Currency

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Attachment 7 - Past Performance Questionnaires

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ATTACHMENT 7: PAST PERFORMANCE QUESTIONNAIRE

Please complete the following questionnaire and return it to Margaret Tse at margaret.tse@occ.treas.gov or 202-649-8168 no later than Friday, July 11, 2014 at 2:00 pm Eastern Time.

Reference’s Name:

Reference’s Company:

Reference’s Title:

Company you are assessing:

Contract number of company you are assessing:

Period of performance of contract you are assessing:

Dollar value of contract you are assessing:

General description of services under contract you are assessing:

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 very high or very low rating should be noted on the last page.

Assign each area a rating of: 4 (Outstanding), 3 (Good), 2 (Acceptable), 1 (Unsatisfactory) and N/A (Not Applicable). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating.

QUALITY OF SERVICE:

1. Compliance with contract requirements:

1 2 3 4 N/A

2. Accuracy of reports:

1 2 3 4 N/A

3. Level of knowledge, experience, and training of personnel:

1 2 3 4 N/A

4. Capability of personnel to perform required services:

mailto:margaret.tse@occ.treas.gov

5. Effectiveness of personnel in performing required services:

6. Overall quality of service:

TIMELINESS OF PERFORMANCE:

1. Reliability:

2. Responsive to technical direction:

1 2 3 4 N/A

3. Meets deadlines:

BUSINESS RELATIONS:

1. Effective management, including subcontracts:

2. Reasonable/cooperative behavior:

1 2 3 4 N/A

3. Responsive to contract requirements:

1 2 3 4 N/A

4. Notification of problems:

1 2 3 4 N/A

5. Flexibility:

1 2 3 4 N/A

6. Pro-active vs. reactive:

COST CONTROL

1. Current, accurate and complete billings:

2. Relationship of negotiated costs to actuals:

3. Cost efficiencies:

CUSTOMER SATISFACTION

1. The contractor is committed to customer satisfaction:

a. Contractor Management Personnel

(circle one) Yes No

b. Contractor Onsite Facility Personnel

(circle one) Yes No

ADDITIONAL COMMENTS:

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