Past Performance Questionnaire Casualty Actuary Services.doc

Part I- Past Performance Questionnaire (FACTOR 1) (To be completed and submitted by the Reference) Past Performance

(Due Not later than April 15, 2010, 3:00PM local time for Washington, DC)

1. Complete name of government agency, commercial firm or other organization

2. Complete address

3. Contract number or other reference

4. Date of contract award

5. Date work was begun

6. Date work was completed

7. Initial contract price

8. Final amount invoiced or amount invoiced to date

9. Technical point of contact (name, address, telephone no. and email address)

10. Location of work (country, state or province, county, city)

11. Description of contract work

All Questionnaires are due not later than April 15, 3:00PM Washington, DC local time

Mail or fax questionnaires to the following information:

OASAM Office of Procurement Services

Attn: Gladys Bailey

200 Constitution Avenue, NW

RM S4307

Washington, DC 20210

Fax: 202-693-4579

Tel: 202-693-4598

Past Performance Questionnaire (To be completed and submitted by the Reference) ***Please circle or type a response and any comments Performance History:

1. To what extent did the contractor adhere to contract delivery schedules?

Considerably surpassed minimum requirements

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

COMMENTS:

2. To what extent were the contractor’s reports and documentation accurate and complete?

Considerably surpassed minimum requirements

Exceeded minimum requirements

Met minimum requirements

Less than minimum requirements

3. To what extent was the contractor able to solve contract performance problems without extensive guidance from government counterparts?

Considerably successful

Generally successful

Little success

No success

4. To what extent did the contractor display initiative in meeting requirements?

Displayed considerable initiative

Displayed some initiative

Displayed little initiative

Displayed no initiative

5. Did contractor commit adequate resources, in a timely fashion, to the contract to meet the requirements and to successfully solve problems?

Provided abundant resources

Provided sufficient resources

Provided minimal resources

Provided insufficient resources

6. To what extent was the contractor effective in interfacing with Government staff?

Extremely effective

Generally effective

Generally ineffective

Extremely ineffective

7. What was the overall performance of the contractor?

Excellent

Good

Satisfactory

Unsatisfactory

Cost Management:

1. To what extent did the contractor meet the proposed estimates?

Less than estimated cost

Comparatively equal to estimate

Exceeded the costs

Considerably surpassed estimate

2. To what extent were there cost overruns?

No cost overruns

Little cost overruns

Some cost overruns

Considerable cost overruns