Technical_Exhibit_2_-_Surveillance_Checklist.pdf

TECHNICAL EXHIBIT 2: QUALITY ASSURANCE MONITORING FORM

SERVICE or STANDARD:

SURVEY PERIOD:

SURVEILLANCE METHOD (Check):

Random Sampling 100% Inspection Periodic Inspection Customer Complaint

LEVEL OF SURVEILLANCE (Check):

Monthly Quarterly As needed

PERCENTAGE OF ITEMS SAMPLED DURING SURVEY PERIOD: ______ %

Performance

Element

Description

Performance

Rating

Quality of Service

Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety health standards).

Schedule

Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, and delivery schedule, administrative requirements (e.g., efforts that contribute to or effect the schedule variance).

Business Relations

Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history or reasonable and cooperative behavior, customer satisfaction, timely award and management of subcontracts.

Management of Key

Personnel

Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

Cost Control Assess the contractor’s performance in cost increase/decrease on labor hours or materials or Level of Effort. Firm fixed price contract is not applicable for this element.

ANALYSIS OF RESULTS:

Observed Service Provider Performance Measurement Rate: ______%

Service Provider’s Performance (Check): Meets Standards

Does Not Meet Standards

Narrative of Performance During Survey Period:

PREPARED BY: ___________________________________ DATE: _________________