ATTACHMENT_D-_PAST_PERFORMANCE_QUESTIONNAIRE.docx

ATTACHMENT D PAST PERFORMANCE QUESTIONNAIRE

BACKGROUND:

The U.S. Census Bureau is currently seeking a contractor who will provide national address data or remotely sensed satellite and/or aerial imagery. .

The information hereby requested is intended to assist the U.S. Census Bureau to assess the effectiveness and performance of the services/contractor identified below.

INSTRUCTIONS:

Two forms are provided to document the evaluator’s option: 1) Performance Rating Form; and 2) Supplemental Comment Form. The following standards shall be used in arriving at the rating.

(S) - Satisfactory Contractor/ Service met or exceeded customer expectations or contract requirements and demonstrated an acceptable understanding of the requirements.

(U) - Unsatisfactory Contractor’s performance / Service was either marginal or did not meet customer expectations or contract requirements.

N/A Element is not applicable. If no data has been obtained, please note in this column.

Please submit this form no later than 5:00 PM EST, on May 15, 2015, as an e-mailed attachment to:

· Matthew Gore, Contract Specialist, (matthew.s.gore@census.gov)

Please mark the subject line of the e-mail as CENSUS2015-GEO0227- [Offeror Name] – Phase II: Past Performance

A. Performance Rating Form

B. NAME OF CONTRACTOR EVALUATED:

C. NAME OF SERVICES EVALUATED:

ADDRESS OF CONTRACTOR EVALUATED:

POINT OF CONTACT OF CONTRACTOR EVALUATED:

NAME OF EVALUATOR/ PHONE #/EMAIL:

EVALUATOR’S AGENCY:

CONTRACT NUMBER:

CONTRACT TOTAL VALUE:

CONTRACT PERIOD OF PERFORMANCE:

DATE OF EVALUATION:

DESCRIPTION OF SERVICES RECEIVED:

Please provide a brief description of the services evaluated.

(1) SERVICE PERFORMANCE

1 - OVERALL PERFORMANCE: How would you rate the overall performance and quality?

Comments:

XXx

2 - EASE TO USE: Was the data easy to understand? Easy to use?

x

3 - QUALITY OF DATA: Was the data provided comprehensive? Current?

Were the reports clear, comprehensive, easy to understand?

x

(2) CONTRACTOR PERFORMANCE

4 –QUALITY ASSURANCE: Did the contractor demonstrate a high regard for quality assurance? In what specific ways?

5 – CUSTOMER SERVICE:

Comment.

For the following questions, please answer “Yes” or “No”, as appropriate. Please elaborate on your answer:

1 - Were there any quality deficiencies or concerns during the performance period?

____ _NO

_____ YES, please explain.

2 - Do you have any reservations about recommending the services?

____ _NO

_____ YES, please explain.

3 – Given the choice, would you do business with this contractor again?

_____ YES.

_____NO, please explain.

Please provide any additional comments that may assist the Census Bureau in evaluating the performance of the referenced service and contractor.

Thank You.