PAST_AND_PRESENT_PERFORMANCE_SURVEY.pdf

ATF Solicitation No. DJA-18-AHDQ-R-0003 for Medic Support Services

- 1 - Attachment I

PAST AND PRESENT PERFORMANCE SURVEY

A. GENERAL INFORMATION:

Contractor’s Name:

Project Title or Brief Description of Work:

Contract Number Provided by Offeror:

Contract Dollar Amount: $

Types of work performed:

Contract Period or Dates of Performance Provided by Offeror:

Contractor performed as the (1) Prime Contractor (2) Sub-Contractor

B. RESPONDENT INFORMATION (Point of Contact, Agency and Address):

POC Name:

Address:

Agency:

Phone: Fax: ______________ Email Address:

C. EMAIL COMPLETED SURVEY FORM TO: Brian.Wilkins@atf.gov

D. PERFORMANCE INFORMATION: Choose the letter on the scale that most accurately describes the contractor’s performance or situation. PLEASE

PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF

Unsatisfactory.

ATF Solicitation No. DJA-18-AHDQ-R-0003 for Medic Support Services - 2

- Attachment I

E G S U N Exceptional Good Satisfactory Unsatisfactory Neutral Based on the Offeror’s record of past performance, no issues, concerns, or risks are associated with receiving timely services and contract performance. Past performance surveys and the Offeror’s experiences indicate that the Offeror is capable of significantly exceeding the requirements of the

RFP.

The Offeror’s record of past performance indicates there is very little risk associated with receiving quality products, timely services and full contract performance.

Past performance surveys and the Offeror’s experience indicate the Offeror is capable of exceeding the requirements of the RFP.

The Offer’s record of past performance indicates that there is some potential risk associated with receiving quality products, timely services, and contract performance. Past performance surveys and the Offeror’s experience indicate the Offeror is capable of meeting the requirements of the RFP.

The Offeror’s record of past performance indicates it is likely to have problems meeting the requirements of the

RFQ.

No past performance/exp erience available for evaluation.

Offeror has asserted that it has no directly related or relevant past performance experience.

Proposal receives no merit or demerit for this factor.

QUALITY OF SERVICE (Circle Response)

Contractor's ability to meet minimum quality standards specified for performance

E G S U N N/A

Contractor's ability to effectively control the quality of services provided

E G S U N N/A

3 Contractor's compliance with contractual terms and conditions E G S U N N/A

4 Overall rating of contractor's quality of service E G S U N N/A

TIMELINESS OF PERFORMANCE (Circle Response)

Contractor's ability to meet specific response times and scheduled timeframes for completion of specific tasks. E G S U N N/A

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

E G S U N N/A

3 Contractor's timeliness in responding to emergency services requirements.

E G S U N N/A

4 Overall rating of contractor's responsiveness/timeliness. E G S U N N/A

BUSINESS RELATIONS (Circle Response)

Contractor's ability to identify problems and potential problems and promptly notify the Contracting Officer E G S U N N/A

ATF Solicitation No. DJA-18-AHDQ-R-0003 for Medic Support Services

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Contractor's ability to correct problems and prevent or mitigate potential problems in a timely manner. E G S U N N/A

Contractor's willingness to improve and correct noncompliance issues or concerns. E G S U N N/A

Contractor's ability to use effective approaches and provide technical expertise and resources to solve contract problems. E G S U N N/A

Extent to which the contractor has demonstrated reasonable and cooperative behavior. E G S U N N/A

Contractor's working relationship with the Contracting Officer, quality assurance personnel, and customers. E G S U N N/A

Contractor's flexibility in satisfying the requirements of its customers. E G S U N N/A

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

E G S U N N/A

9 Overall rating of business relations. E G S U N N/A

MANAGEMENT OF KEY PERSONNEL (Circle Response)

Contractor's ability to select and retain cooperative and effective key personnel, such as the contract manager and quality control personnel.

E G S U N N/A

Extent key personnel were knowledgeable about contractual requirements. E G S U N N/A

Contractor's ability to meet appropriate staffing levels with qualified personnel in order to provide required services. E G S U N N/A

4 Overall rating of contractor's management of key personnel. E G S U N N/A

COMPLIANCE WITH ENVIRONMENTAL, SAFETY, HEALTH, AND SECURITY REQUIREMENTS (Circle Response)

1 Has the contractor ever received any Notices of Violations for noncompliance with environmental laws or regulations?

YES NO

2 Contractor's compliance with safety requirements. E G S U N N/A

3 Contractor's compliance with security requirements. E G S U N N/A

CONTRACTUAL CONSIDERATIONS (Circle Response)

Has an election ever been made not to exercise an option or continue relations due to contractor's poor performance? YES NO

2 Has a Contract Discrepancy Report ever been issued? YES NO

3 Has a Cure Notice or Show Cause Notice ever been issued? YES NO

4 Extent to which the contractor provided reliable, supportable cost estimates or proposals.

E G S U N N/A

ATF Solicitation No. DJA-16-AHDQ-R-0099 for Institute of Makers of Explosives Safety Analysis for Risk (IMESAFR) for Support Services - 4 - Attachment I

5 Overall rating of contractor's performance under this contract. E G S U N N/A

6 Would you hire this contractor again? YES NO

WHAT IS YOUR OVERALL ASSESSMENT OF

FACTOR 1, PAST PERFORMANCE? (Circle Response)

E G S U N N/A