Past_Performance_Questionnaire_Template_Solicitation_DJA-16-AHDQ-R-0006.pdf

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Wellness Program Counselor
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DJA-16-AHDQ-R-0006
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Past Performance Questionnaire Solicitation DJA-16-AHDQ-R-0006

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PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS

Please complete the following questionnaire and return it to the attention of the ATF Contract Officer, Craig Drew, at the designated e-mail address below. This questionnaire pertains to a requirement to obtain development and integration services to develop and implement an investigative criminal law enforcement and regulatory case management system to support the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) Special Agents and Industry Operations Investigators (IOI) functions, based upon a Business Process Management Suite (BPMS)/Case Management (CM) Commercial Off-the-Shelf (COTS) tool, utilizing Agile scrum development best practices.

Past Performance is an extremely important part of the evaluation criteria for this acquisition, so your input is very important.

The information is to be provided directly to the ATF Contract Officer. Please provide an honest assessment and return the questionnaire to the following e-mail address: Craig.Drew@atf.gov by close of business on .

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify the information that you have provided. Thank you for your assistance in returning this questionnaire by the required date.

GENERAL INFORMATION

1. OFFEROR’S NAME AND ADDRESS 2. CUSTOMER ORGANIZATION

3. CONTRACT NUMBER: 2a. INDIVIDUAL RESPONDING

4. ESTIMATED CONTRACT VALUE: NAME:

5. CONTRACT AWARD DATE: TITLE:

6. PERIOD OF PERFORMANCE: TO PHONE NO:

7. CONTRACT TYPE 8. COMPLEXITY OF WORK

(Check Responses All That Apply): (Check ONLY One Response):

Cost-Plus Fixed Price Fixed Price

Cost-Plus Award Fee OTHER

Time & Material

THE COMPANY’S ROLE Prime

Sub-Contractor

Teaming Partner

TYPE AND EXTENT OF SUBCONTRACTING:

Difficult

Routine v 1.0 Page 1 of 4 Procurement Sensitive – For Official Use Only

SOURCE SELECTION SENSITIVE INFORMATION

COMPANY PERFORMANCE RATING

Please evaluate the Company’s performance in each question. Determine rating that most nearly represents your experience with this Company and indicate your assessment by placing an “X” under the appropriate heading.

Adjectival ratings are defined below and should be used as a reference in assessing performance:

Adjectival Ratings Description Exceptional/Blue Performance of previous relevant contracts/orders demonstrates an overall performance and quality record that supports an extremely strong expectation of successful achievement of the SOO requirements.

Very Good/Green Performance of previous relevant contracts/orders demonstrates an overall performance and quality record that supports a strong expectation of successful achievement of the SOO requirements.

Satisfactory/Yellow Performance of previous relevant contracts/orders demonstrates an overall performance and quality record that supports an expectation of satisfactory achievement of a great majority of SOO requirements.

Marginal/Red Performance of previous relevant contracts/orders demonstrates a general trend that supports an expectation that successful achievement of the SOO requirements may be difficult or can occur only with increased levels of ATF oversight.

Unsatisfactory/Black Performance of previous relevant contracts/orders demonstrates a general trend that supports a strong expectation that successful achievement of the SOO requirements is impossible.

Neutral/Grey No relevant past performance available for evaluation, asserting that you have no directly-related or similar-relevant past performance experience.

Exceptional Satisfactory Marginal Unsatisfactory Neutral

Quality of Product/Service

Contractor’s ability to provide software solutions in an agile development environment that fully met your intended objectives.

Contractor's compliance with contractual terms and conditions.

Overall rating of contractor's quality of service.

Timeliness of Performance

Contractor's ability to meet specific response times and scheduled timeframes for completion of specific tasks in adherence with the schedule.

Contractor's responsiveness/timeliness for providing administrative reports/documentations required by contract.

Contractor's timeliness in responding to emergency services requirements.

Business Relations

Contractor's ability to identify problems and potential problems and promptly notify the Contracting Officer.

Very Good v 1.0 Page 2 of 4

The below section is provided for any comments or insights regarding your above ratings.

COMMENTS OR INSIGHTS (Continue on next page if needed):

Exceptional Satisfactory Marginal Unsatisfactory Neutral

Contractor's ability to correct problems and prevent or mitigate potential problems in a timely manner.

Contractor’s ability to manage the project using an effective project management system or approach that included planning, budgeting, status tracking, cost reporting, baseline management, critical path analysis, and work breakdown structure.

Contractor's flexibility in satisfying the requirements of its customers.

Contractor’s ability to execute the Statement of Work in a consistently effective and high quality manner.

Contractor's working relationship with the Contracting Officer, quality assurance personnel, and customers.

Extent to which the contractor provided prompt and courteous service when responding to customer complaints.

Contractor’s ability to successfully collaborate with other contractors involved in the project.

Extent to which the contractor has demonstrated reasonable and cooperative behavior.

Contractor’s effectiveness in developing and implementing an effective quality assurance program.

Contract Management and Other Contractual Considerations Extent to which the contractor provided reliable, supportable cost estimates or proposals.

Contractor completed the project within the proposed cost.

Extent key personnel were knowledgeable about contractual requirements.

Contractor's ability to meet appropriate staffing levels with qualified personnel in order to provide required services.

Has an election ever been made not to exercise an option or continue relations due to contractor's poor performance?

Yes No

Has a Contract Discrepancy Report ever been issued? Yes No

Has a Cure Notice or Show Cause Notice ever been issued? Yes No

Would you hire this contractor again? Yes No

Very Good v 1.0 Page 3 of 4

COMMENTS OR INSIGHTS (Cont.):

v 1.0 Page 4 of 4

PAST PERFORMANCE QUESTIONNAIRE

TYPE AND EXTENT OF SUBCONTRACTING:
Period of Performance - From:
Period of Performance - To:
Contract Number:
Estimated Contract Value:
Contract Award Date:
Respondent Name:
Respondent Title:
Respondent Phone Number:
Offerors Name and Address:
Cost-Plus Fixed Price: Off
Cost-Plus Award Fee: Off
Fixed Price: Off
Time and Material: Off
Other (Contracting Type): Off
Quality of PS2: Off
Quality of PS3: Off
Timeliness2: Off
Timeliness1: Off
Timeliness3: Off
BusinessRelations1: Off
BusinessRelations2: Off
BusinessRelations3: Off
BusinessRelations4: Off
BusinessRelations5: Off
BusinessRelations6: Off
BusinessRelations7: Off
BusinessRelations8: Off
BusinessRelations9: Off
BusinessRelations10: Off
ContractMgmt1: Off
ContractMgmt2: Off
ContractMgmt3: Off
ContractMgmt4: Off
NoOption-Perf: Off
CDR_Issued: Off
Cure_Notice: Off
HireAgain: Off
Company Role: Off
Quality of PS1: Off
Complexity of Work: Off
Submission Deadline: 02/19/2016
FR_00000_CALENDARBUTTON_Submission Deadline:
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CalendarHead: mm/dd/yyyy
CalendarMonth: [2]
CalendarYear: 2015
CalendarFrame:
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Comments Or Insights:
Comments Or Insights (cont):
Submit Via Email:
Button5:
Customer Organization:
Recipient Email: [Brian.Wilkins@atf.gov]
Contract Description: Please complete the following questionnaire and return it to the attention of the ATF Contract Officer, Brian Wilkins at the

designated e-mail address below. This questionnaire pertains to a requirement to for Wellness Program Counselor as outlined in the SOW to support the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) Office of Human Resources .

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