PAST_PERFORMANCE_QUESTIONNAIRE_Joyce.docx

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

TO REFERENCE:

(Name of Person Providing Reference)

REFERENCE’S PHONE NUMBER: EMAIL:

REQUESTING FIRM:

(Name of Firm and contact information of the person requesting the accomplishment of the questionnaire.)

Please complete this Questionnaire and forward a PDF OR Word copy to:

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

SECTION I - TO BE COMPLETED BY OFFEROR

3. PERIOD OF PERFORMANCE:

4. COMPETITIVELY AWARDED: |_| Yes |_| No

5. INITIAL CONTRACT VALUE (with options): $

6. CURRENT CONTRACT VALUE (with options): $

7. TYPE OF CONTRACT:

8. REASONS FOR DIFFERENCE (IF ANY) BETWEEN INITIAL CONTRACT VALUE AND CURRENT CONTRACT VALUE:

9. DESCRIPTION OF CONTRACT REQUIREMENTS: (Please give a detailed description of the work performed on the contract)

Please add a continuation page if additional space necessary.

SECTION II - EVALUATION - TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

Name:

Position Relative To Contract:

Phone Number:

Email Address:

Years/Months Evaluator Has Monitored Contractor’s Performance:

12. INDIVIDUAL RATINGS EVALUATION: Please indicate your satisfaction with the contractor’s performance on the next page by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

PERFORMANCE EVALUATION

Quality of Products/Services

a) Understand/complied with customer objectives and technical requirements

b) Retained Key Personnel, staff and subcontractors with sufficient qualifications, experience and had successful methods for accommodating changes in staffing levels in a dynamic environment which yielded efficient, effective and adaptable planning and execution of the program

c) Contractor implemented responsive/flexible processes to improve quality and timeliness of support.

d) The Contractor’s management plans and reports met the customer’s requirements and resulted in efficient, effective and adaptable program planning, execution, and maintenance.

Timeliness and Schedule Management

e) Timeliness of contract problem resolution without extensive customer guidance

f) Transition or phase in of contract met agreed upon milestones or were managed without significant impact to agency

g) Successfully responded to emergency and/or surge situations

Management Capability

h) Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

i) Obtained and maintained the personnel required for successful contract execution

j) Successfully managed an integrated team inclusive of subcontractors/teammates

k) Responded in a prompt and acceptable manner to resolve problems

Subcontracting and Small Business Participation

l) Quality/effectiveness of sub-contracted efforts

m) Ability to meet or exceed small business and small disadvantaged business goals set forth in the approved subcontracting plan.

n) Ability to effectively manage small business participation to meet technical performance.

Cost Control and Cost Performance

o) Accuracy in forecasting contract costs

p) Demonstrated ability to meet forecasted costs and perform within contract costs

q) Demonstrated ability to alert Government of unforeseen costs before they occur

r) Sufficiency and timeliness of cost reporting

Customer Satisfaction

s) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)

t) Contractor proposed alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the customer

u) Effectiveness of contract problem resolution without extensive customer guidance

13.

Please provide any additional comments in response to any of the items above.

14. OVERALL EVALUATION RATING (select one):

|_| EXCEPTIONAL |_| VERY GOOD |_| SATISFACTORY |_| UNSATISFACTORY |_| MARGINAL |_| NOT OBSERVED

15. Any unsatisfactory performance identified above has been shared with the contractor?

|_| Yes If yes: |_| Written |_| No

16. Government Contracts ONLY: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

|_| Yes If yes: |_| Default |_| Convenience |_| Pending Terminations |_| No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

17. Would you have any reservations about soliciting this Contractor in the future or having them perform one of your critical and demanding programs?

|_| Yes |_| No

If yes, please explain.