Attachment_2_Past_Performance_Survey.docx

Attachment 2

Survey to be completed by References and sent directly to the Contract Specialist

PAST PERFORMANCE EVALUATION SURVEY

RE: DU100G-12-R-0006

FROM:

(Insert Name of Firm or Organization)

Name of Offeror: ____________________________________________________

Contract Number: ____________________________________________________

Contract Type: ______________________________________________________

Award Date: ____________________ Completion Date: _________________

Contract Value: ___________________________________________________

GTR/Contact Name: ______________________________________________

GTR/ Contract Title: _______________________________________________

GTR/Contract Phone Number: _______________________________________

Check all the following contract types that apply:

_____ Firm-Fixed Price (FFP) _____ Fixed-Price, Economic Price Adjustment (FP-DPA) _____ Cost-Plus-Fixed-Fee (CPFF), Completion or Term _____ Cost-Plus-Incentive-Fee (CPIF) _____ Cost-Plus-Award-Fee (CPAF) _____ Cost Plus No Fee _____ Cost Sharing _____Indefinite Delivery/Indefinite Quantity (IDIQ) _____ Federal Supply Schedule _____ Requirements _____ Labor Hours _____ Time and Materials (T&M)

Description (s) of Products or Services Provided

Please rate the company listed in 1 above on the contracts listed in 2 above. Please provide comments to describe your ratings. Detailed comments are the most useful in the evaluation process. Your name will not be shared with the firm evaluated, but any adverse results that they are unaware of will be provided to them for comment only.

Quality of Service Performance:

Reliability: Describe the Offeror’s success in meeting contract requirements relating to service performance.

_____Excellent _____Good _____Fair _____Poor _____Unacceptable

Comments:

Reports: Were users able to access the reports as needed? Was the data reliable?

_____Excellent _____Good _____Fair _____Poor _____Unacceptable

Comments:

Overall Quality of Product/Services:

_____Excellent _____Good _____Fair _____Poor _____Unacceptable

Comments:

Timeliness of Performance:

_____Excellent _____Good _____Fair _____Poor _____Unacceptable

Comments:

Business Relations:

_____Excellent _____Good _____Fair _____Poor _____Unacceptable

Comments:

Would you select this firm again?

_____Yes _____No

Explain:

Preparer Name: ___________________________________________________________ (Please Print) Preparer Phone Number: ___________________________________________________ Preparer Signature: _______________________________________________________ Please return this survey to:

Kenneth L. Gipson, Contract Specialist Department of Housing & Urban Development - Fax: (202) 708-2933