PAST_PERFORMANCE_QUESTIONNAIRE.doc

ATTACHEMENT 3

PAST PERFORMANCE QUESTIONNAIRE

The Department of the Treasury, IRS Procurement Services Division requests your assistance in providing past performance information on the company listed below for the contract referenced below. Please complete the questionnaire, scan, and e-mail to the Department of the Treasury using the addresses listed below by 19 June 2013:

E-mail:

Phone Number:

Mail:

Department of the Treasury IRS Procurement Services Division 6009 Oxon Hill Road, 7th Floor Oxon Hill, MD 20745 Attn: Pamela Robinson / 7-322

INSTRUCTIONS:

For each item, circle the rating that best describes the contractor's work on the contract, or if you do not know how the contractor performed (or is performing on a particular item), please circle (Not Applicable (N/A) on that item. The rating scale is defined below.

Not Applicable (N/A): Does not apply or you do not know.

Unsatisfactory Achievement of contract requirement is compromised

Poor

Requires major agency resources to ensure achievement of contract requirements.

Fair

Requires minor agency resources to ensure achievement of contract requirements.

Good

Does not impact achievement of contract requirements

Excellent

No problems, issues, or delays in achieving contract requirements

Outstanding Cases where contractor performance exceeds Excellent

CONTRACT INFORMATION

Type of contract (Check all that apply)

Negotiated

[ ] Sealed Bidding Competitive

Non-Competitive [ ] Firm-Fixed-Price

Requirements

[ ] Cost-Plus-Fixed-Fee [ ] Time-and-Material Indefinite Quantity

Labor Hour [ ] Other _______________

Complete the following:

Period of Performance: _____________________ to ______________________

Initial Contract Value: $____________________

Current (or Completed) Contract Value: $_____________________

Brief Description of Requirement:

Complexity of Effort: [ ] Difficult [ ] Routine

1.

QUALITY OF SERVICE:

(a) Overall ability to pro-actively and aggressively perform contract requirements(s).

0 1 2 3 4 5 6 Comment: _____________________________________________________

(b) Effectiveness, reliability, and technical proficiency of contractor's key personnel.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(c) Ability to recruit and maintain qualified personnel.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(d) Ability to satisfy security requirements (clearances for personnel, information protection, facilities, etc.).

0 1 2 3 4 5 6 Comment: _____________________________________________________

(e) Ability to effectively implement "start-up" contract performance.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(f) Ability to appropriately manage IT systems and data in a classified environment 0 1 2 3 4 5 6 Comment: _____________________________________________________

2.

TIMELINESS OF PERFORMANCE

(a) Overall performance in planning, scheduling, and monitoring the work effort.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(b) Completion of major milestones on schedule:

0 1 2 3 4 5 6 Comment: _____________________________________________________

(c) Responsiveness and flexibility in responding to changes (both formal and informal).

0 1 2 3 4 5 6 Comment: _____________________________________________________

(d) Responsiveness/capability to respond to surge/short term requirements.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(e) Timely completion of efforts within period of performance.

0 1 2 3 4 5 6 Comment: _____________________________________________________

3.

PRICE/COST CONTROL:

(a) Quality, completeness, and accuracy of price/cost proposals.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(b) Accuracy and timeliness of cost reports.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(c) Ability to perform within negotiated cost/price.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(d) Accuracy and completeness of vouchers/invoices.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(e) Incurrence of costs is in accordance with contract terms.

0 1 2 3 4 5 6 Comment: _____________________________________________________

4.

BUSINESS RELATIONS:

(a) Ability to effectively manage contract.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(b) Ability to choose subcontracts (if applicable to this contract being reported on).

0 1 2 3 4 5 6 Comment: _____________________________________________________

(c) Ability to manage subcontracts (if applicable to this contract being reported on).

0 1 2 3 4 5 6 Comment: _____________________________________________________

(d) Provides prompt notification of problems.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(e) Organizational support structure provides adequate span of control and supervision.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(f) Has the contractor been given letters of concern(s), cure notice(s), show cause notices(s), suspension of progress payments, or letters of direction, etc.?

0 1 2 3 4 5 6 Comment: _____________________________________________________

5.

CUSTOMER SATISFACTION:

(a) Maintains a single effective point of contact to manage and resolve problems.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(b) Effectively assesses impacts of potential changes on other associated projects, tasks, and efforts.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(c) Effectiveness in interfacing with Government personnel.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(d) Ability to solve contract performance problems without extensive guidance from Government personnel.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(e) Displays initiative in meeting Government requirements and is responsive to the Government's needs.

0 1 2 3 4 5 6 Comment: _____________________________________________________

(f) Rate the contractor's overall technical performance on this contract.

0 1 2 3 4 5 6 Comment: _____________________________________________________

6.

Has this contractor exhibited an outstanding ability to adhere to all contractual terms and conditions?

0 1 2 3 4 5 6 Comment: _____________________________________________________

7.

To your knowledge, does this contractor follow all instructions issued by the contracting officer?

0 1 2 3 4 5 6 Comment: _____________________________________________________

8.

To your knowledge, has this contractor been part of an unauthorized commitment (ratification action)?

0 1 2 3 4 5 6 Comment: _____________________________________________________

9.

Based on this contractor's overall performance, would you award this contractor another Government contract?

[ ] YES

[ ] NO

If no, please explain: _________________________________

10.

Please provide any additional comments concerning the past performance of the contractor.

11.

This questionnaire was completed by:

(Print Name)

(Title)

(Organization)

(Commercial Telephone Numbers)

(Date of Completion)