AttachmentL_ContractorInformationForm_12_pagenumbers.doc

ATTACHMENT L

U.S. Department of Education

CONTRACTOR PERFORMANCE INFORMATION

Contract Number:

2.

Type of Contract:

3.

Contract Value (Current plus any unexercised options):

Period of Performance (including any option periods):

5. Description of Requirement:

6.

Ratings. Summarize contractor performance and circle or type in the number below that corresponds to the performance rating for each category. Please see the attachment, which explains the rating scale.

Quality:

ADVANCE \d2Comments:

Comments:

Comments:

Comments:

Comments:

Comments:

7. Total score:

Evaluated by:

Agency/Organization Date ____________

(In accordance with the Federal Acquisition Streamlining Act, the following information will not be released to the contractor.)

Name and Title _________________________________________________ Telephone number ____________

Signature _____________________________________________ E-mail address _______________________

Please return this form to the following address:

U.S. Department of Education

Contracts & Acquisitions Mgmt.

Potomac Center Plaza

550 12th Street, SW Room 7120 Washington, DC 20202

Attn: Natasha Boyce Or e-mail to:

Natasha.Boyce@ed.gov

Or fax to:

Attn: Natasha Boyce 202-245-6128

SOURCE SELECTION INFORMATIONSEE FAR 3.104

Information entered on this form will be used in source selection decisions and is protected under subsection 3.104 of the Federal Acquisition Regulation. Do not disclose information entered on this form to the contractor or to any other person except as authorized by the Department of Education contracting officer.

Supplementary Questions To assist the Department of Education contracting officer, we would greatly appreciate your taking the time to answer the following questions, if any, related to the contractor’s past performance:

Contractor Performance Evaluation

Instructions for Completing Contractor Performance Information Form

Based on the rating area elements presented below and the rating guidelines on the back of this sheet, please evaluate contractor performance in each of the rating areas. On the Contractor Performance Information form, circle (or type in the Comments: area) the rating from 0 to 4 that most closely matches your evaluation of the contractors performance. Please add written comments for each rating. If you wish, you may attach additional comments or information. We would also appreciate your answers to the specific questions, if any, on the back of the form. Please return the form to the address indicated on the back of the form. Thank you for your time and your cooperation.

The Department of Education will use the information from this form to evaluate offerors competing for contract awards. We may release the information from this form to the contractor during negotiations or debriefings. If we release information from this form, we will not release your name to the contractor.

Elements within Each Rating Area Quality of Product or Service Compliance with contract requirements

Accuracy of reports

Appropriateness of personnel

Technical excellence

Problem Resolution

Anticipates and avoids or mitigates problems

Satisfactorily overcomes or resolves problems

Prompt notification of problems

Pro-active

Effective contractor-recommended solutions

Cost Control Within budget

Current, accurate and complete billings

Costs properly allocated

Unallowable costs not billed

Relationship of negotiated costs to actual

Cost efficiencies

Timeliness of Performance

Meets interim milestones

Reliable

Stays on schedule despite problems

Responsive to technical direction

Completes work on time, including wrap-up and contract administration

No liquidated damages assessed

Business Relations

Effective management

Use of performance-based management techniques

Business-like concern for the customer's interests

Effective management and selection of subcontractors

Effective small/small disadvantaged business subcontracting program

Reasonable/cooperative behavior

Effective use of technology in management and communication

Flexible

Minimal staff turnover

Maintains high employee morale

Resolves disagreements without being unnecessarily litigious.

Customer Service

Understands and embraces service and program goals

Team approach with the customer

Satisfaction of end users with the contractors service

Positive customer feedback

Prompt responses

Courteous interactions

Effective escalations and referrals

Initiative and proactive improvements

Creative service strategies

Rating Guidelines Quality of Product or Service

Problem Resolution

Cost Control

Timeliness of Performance

Business Relations

4 - Excellent

Customer Service Highly effective, proactive business practices focused on customer support.