ELECTRONIC PRINT TO MAIL -Past Performance Questionnaire.pdf

OFFICE OF PROCUREMENT

OFFICE OF THE CHIEF FINANCIAL OFFICER

United States Patent and Trademark Office 600 Dulany Street

Alexandria, Virginia 22313-1450

WWW.USPTO.GOV

CONTRACTOR PAST PERFORMANCE REFERENCE CHECK

AGENCY REQUESTING REFERENCE INFORMATION:

SOLICITATION NUMBER: RFQ# DOC52PAPT1200058

DESCRIPTION OF REQUIREMENT: ELECTRONIC PRINT-TO-MAIL SERVICES

CONTRACT SPECIALIST: Stacy Duncan (stacy.duncan@uspto.gov);

phone - 571.272.2796; fax – 571.273.2796

Contractor seeking reference shall complete the following:

CONTRACTOR NAME:

CONTRACTOR POC/PHONE/EMAIL:

CONTRACT NUMBER SEEKING REFERENCE FOR:

AGENCY HOLDING CONTRACT:

AGENCY POC/PHONE/EMAIL:

DESCRIPTION OF CONTRACT:

CONTRACT VALUE (ALL OPTIONS):

CONTRACT TYPE:

PERIOD OF PERFORMANCE:

(Please see next page for Reference input.)

mailto:stacy.duncan@uspto.gov

Past Performance Reference

RFQ DOC52PAPT1200058, ATTACHMENT 1

United States Patent & Trademark Office

Office of Procurement

REFERENCING AGENCY:

Please complete the following as completely as possible. When complete, please return directly to:

Stacy.Duncan@uspto.gov or via facsimile to: 571-273-2796 by COB Friday, September 14, 2012.

Please call 571-272-2796 with any questions regarding this form.

Please place an “x” in the box corresponding to the appropriate rating.

Narrative support is welcomed, and may be provided on subsequent pages. Each evaluation criteria is numbered for ease of reference.

RATING DEFINITIONS

(E) = EXCELLENT: Based on the Offeror’s performance record, no doubt exists that the Offeror will successfully perform the required effort. A significant majority of sources of information are consistently firm in their statements that the Offeror’s performance was superior and they would definitely do business with the Offeror again.

(G) = GOOD: Based on the Offeror’s performance record, little doubt exists that he Offeror will successfully perform the required effort. Most sources of information state that the

Offeror’s performance was good or better than average and that they would do business with the Offeror again.

(A) = ACCEPTABLE: Based on the Offeror’s performance record, it is the general opinion that the Offeror may be able to perform the required effort successfully. All sources of information state that the

Offeror’s performance was satisfactory, but did not provide any additional benefit beyond meeting the minimum requirements, and would probably do business with the Offeror again.

(U) = UNACCEPTABLE: Based on the Offeror’s performance record, serious doubt exists that the Offeror will successfully perform the required effort. A significant majority of sources of information consistently stated that the Offeror’s performance was entirely unsatisfactory and that they would not do business with the Offeror again.

(N) = NOT APPLICABLE: Area of evaluation does not apply to this particular Offeror or contract.

QUALITY OF SERVICE E G A U N

1. Compliance with technical requirements

2. Accuracy of reports

3. Quality of work

COST CONTROL E G A U N

4. Current, accurate and complete invoices

5. Stayed within funding limits

TIMELINESS OF PERFORMANCE E G A U N

6. Met delivery schedules

7. Reliability

8. Responsive to technical direction

BUSINESS RELATIONS E G A U N

9. Effective Management, including subcontracts if applicable

10. Reasonableness and cooperativeness

11. Responsiveness to requests/issues

12. Communication

13. Flexibility

CUSTOMER SATISFACTION E G A U N

14. Committed to customer satisfaction

15. Would you recommend the selection of this Offeror?

16. Overall rating of Offeror

Additional Comments (please reference appropriate number from above, and use additional sheets as necessary):

mailto:Stacy.Duncan@uspto.gov