PAST PERFORMANCE SURVEY.doc

DJD-11-R-0012

PAST PERFORMANCE SURVEY

Survey should be completed and Emailed or fax’d to:

Drug Enforcement Administration

Office of Acquisition Management

ATTN: (Nanaesi Amoo) Nanaesi.amoo@usdoj.gov Phone: (202) 307-7801 Fax: (202) 307-4877

EVALUATION PERFORMED FOR PROJECT Management of Hazardous Waste (Evaluators complete Following)

1. Organization: ___________________________________________________________

2. Name & Title: ___________________________________________________________

3. Signature: __________________________________ Date: _____________________

EVALUATION OF Contractor’s Performance

4. Contractor: _______________________________Subcontractor: ______________________________

5. Contract Number: _________________________________________

6. Type of Contract: ( ) Negotiated ( ) Sealed Bid

( ) Cost Reimbursement ( ) Fixed Price ( ) Other: __________________

7. Description and location of work:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. Contract Amount: $__________________ Status: ( ) Active ( ) Completed

9. Date of award: _____________________ Date of completion: ________________

10. Contracting Officer (Name) ________________________________________________________

Telephone NO. ________________ Fax NO. ________________________ Email __________________________

11. Contractor Officer Representative (Name) ____________________________________________

Tele No ______________________ Fax NO. _________________________ Email ___________________________

ASSESSMENT ELEMENTS:

- Conformance with contract requirements, specifications and standards of good workmanship e.g. commonly accepted technical, professional, environmental, or safety and health standards.

-Timeliness of contractor against the completion of the contract, task orders, milestones, delivery schedules, administrative requirements e.g. efforts that contribute to or effect the schedule variance Not required for firm fixed price or firm fixed price with economic price adjustment.

- Assess contractor’s effectiveness in forecasting, managing, and controlling contract cost Integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, -corrective action plans, - proposal submittals,

- and contractor’s history of reasonable and cooperative behavior, - customer satisfaction, - timely award and management of subcontracts and

- if the contractor met small , or small disadvantaged and women-owned business participation goals Contractor’s performance in

- selecting key personnel

- retaining key personnel

- supporting key personnel - replacing when necessary key personnel

ASSESSMENT RATING SYSTEM:

Adjectival and

Points/100

Exceptional

(93-100)

Very Good

(85- 92)

Satisfactory

(89- 84)

Marginal

(70- 77)

Unsatisfactory

(under 70)

PAST PERFORMANCE SURVEY:

HOW WELL DID THE CONTRACTOR PERFORM THE WORK

Quality of Product or Services: Circle or X Rating

1. To what extent did the contractor comply with contract requirements?

1___ 2___ 3___ 4___ 5___

2. If reports were required, were they accurate in meeting contract requirements?

1___ 2___ 3___ 4___ 5___

3. To what extent did the contractor use appropriate personnel for contract requirements?

1___ 2___ 3___ 4___ 5___

4. To what extent did the contractor display technical excellence?

Cost Control: (NOT APPLICABLE TO FIRM FIXED PRICE or FIRM FIXED PRICE W/ECONOMIC PRICE ADJUSTMENTCONTRACTS)

5. To what extent did the contractor remain within budget?

6. To what extent did the contractor provide current, accurate and complete billings?

1___ 2___ 3___ 4___ 5___

7. To what extent did the contractor maintain the relationship of negotiated costs to actuals?

8. To what extent did the contractor maintain cost efficiencies?

9. To what extent was the contractor effective

1___ 2___ 3___ 4___ 5___ in forecasting contract costs?

Schedule

10. To what extent did the contractor meet interim milestones?

11. To what extent was the contractor reliable?

1___ 2___ 3___ 4___ 5___

12. To what extent was the contractor responsive to technical directions?

1___ 2___ 3___ 4___ 5___

13. To what extent did the contractor complete

1___ 2___ 3___ 4___ 5___ contract performance on time, including wrap-up and administration?

Business Relations:

15. To what extent did the contractor display effective management?

16. To what extent did the contractor generate

1__ 2___ 3___ 4___ 5___ businesslike correspondence?

17. To what extent was the contractor responsive to contract requirements?

18. To what extent did the contractor notify the government of problems or potential problems?

19. To what extent was the contractor

1_ 2___ 3___ 4___ 5___ reasonable and cooperative?

20. To what extent was the contractor flexible in responding to changing needs?

21. To what extent did the contractor take pro-active measures in lieu of “knee-jerk” reactions? 2

22. To what extent effective were contractor recommended solutions?

23. To what extent did the contractor maintain an effective business subcontracting program to meet ?

Management of Key Personnel:

24. To what extent did the contractor select

1___ 2___ 3___ 4___ 5___

Key personnel appropriate to meet

Contract requirements?

25. To what extent did the contractor retain qualified key personnel?

26. To what extent did the contractor demonstrate

1___ 2___ 3___ 4___ 5___ the Corporation supported the decisions and actions taken by their key personnel?

27. To what extent did the contractor replace key personnel due to cause or provide immediate replacement upon vacancies?

28. To what extent was the key personnel technical expertise used or the extent the contractor key personnel gained expertise from the contract performance?

Other Informational Comments: Please fill in this section is you gave a rating of Blue

Pro: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Con: Please fill in this section if you gave a rating of Yellow or Red. Explain what caused the rating and have they fixed the problem or placed controls in effect to preclude the problem from happening again.

PAST PERFORMANCE Reference Sheet

A separate reference must be completed for all contracts

That are RELEVANT to services being solicited, within the past THREE years.

All records shall be submitted with proposal.

Reference for Project: Management of Hazardous Waste

1. Contract No.:

2. Contractor (Name, address, zip code reference’s POC)

Name company:

POC (CO or COTR)w/title:________________________________________________________ Address:

Phone:

____________________ Fax: ________________________________

Email:

3. Type of Contract: Negotiated /__/ Sealed Bid /__/

Cost Reimbursement /__/ Fixed Price /__/ Other (explain):

4. Complexity of Work: Difficult /__/ Routine /__/

5. Description, location and relevancy of work:

6. Contract Dollar Value: $__________________

Status: Active /__/ Completed /__/

7. Date of award: _____________________

Date of completion (including extension): ________________

8. Type and Extent of Subcontracting (attach list of subcontractors with nature of their work):

Check box if reference is for a subcontractor of a Prime /___/ Subs name:

9. Name, address, telephone No. & E-mail of Procuring Contracting Office and/or Contracting Officer’s Technical Representative (COTR) (and other references, e.g., Administrative Contracting Officer, if applicable):