Attachment_3_Past_Performance_Questionnaire.docx

ATTACHMENT 3

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

(To be completed by reviewing company/agency)

Submission Instructions: The firm that has provided you with this questionnaire is responding to a Consumer Financial Protection Bureau (CFPB) Request for Proposals (RFP) (CFP-14-R-00006) for DIVERSITY COMPLIANCE SUPPORT SERVICES. Thank you for your participation.

Questionnaire About [insert name of requesting company/contractor]

Company/Contractor Providing Services

Description of Services Provided ______

Company/Contractor’s role (work performed as a Prime or Subcontractor?) __________________

Contract Number/Identifier

Original Contract Estimated Value ____ ____ Estimated Value at Completion ___

Percentage of Work Completed ___________

Contract Performance Period

Contract Type (Fixed Price, Time & Materials, Cost, etc.) ____________

Questionnaire Completed By [insert name of reviewing company/agency]

Thank you, in advance, for providing us with valuable information needed to conduct a past performance evaluation. Upon completion of this questionnaire, please send a signed, scanned version as an email attachment directly to both the CFPB Contracting Officer at Nicholas.Olson@cfpb.gov and CFPB Contract Specialist at Matthew.Chmielewski@cfpb.gov no later than 4:00 p.m. Eastern Time on June 18, 2014. Any submissions submitted to the Contracting Officer after that time may not be considered. In the email subject line, please state “Diversity Compliance Support Services PPQ Submission.” If you have any questions about this questionnaire, please contact Mr. Nicholas Olson at 202-435-7621 or Mr. Matthew Chmielewski at 202-435-9531.

Name

Title

Company/Agency

Address

Telephone Email Address ______

Signature Date

Questionnaire For (insert name of requesting company)

Questionnaire Instructions: Please answer questions 1 through 8, below, by providing a brief statement of your observations during the time you received support/services from the requesting company. If applicable, please describe any problems or performance failures that prompted your comments. Additional pages may be attached if needed. Please note that in the following questions, the term ‘Contractor’ is defined as the requesting company which provides/has provided services to the reviewing company/agency.

Comments:

2.

Describe the quality of service you received from the contractor, including its ability to adequately staff its team with competent personnel. Please note here if the contractor used subcontractors and whether there were proper controls in place to ensure the subcontractor performed in accordance with the contract requirements.

Comments:

3.

Describe the contractor’s ability to adjust to contract, program and/or schedule changes, and to meet established deadlines. If applicable, please identify whether there were any instances where missed deadlines affected the timing of other deliverables and overall contract performance.

Comments:

4.

Describe the contractor’s identification and mitigation of project-related risks.

Comments:

5.

Describe the contractor’s willingness to work as a team with your personnel and with contractor staff from other companies (if applicable).

Comments:

6.

Describe any instances of breaches in security or unauthorized transfers, releases, or sharing of information by the contractor and the contractor’s response.

Comments:

7.

Overall, would you consider the contract performance risk with this contractor for the same or similar services to be high risk, medium risk, or low risk of unsuccessful performance? Please explain the rationale behind your response.

Comments:

8.

Please provide any additional relevant information to assist us in conducting our evaluation of the contractor’s past performance.

Comments: