Attachment_C_Past_Performance_Form.pdf

Attachment C

CONTRACTOR PERFORMANCE INFORMATION

Contractor Name and Address (Identify Division)

1. Contract Number:

2. Type of Contract:

3. Contract Value (Current plus any unexercised options): $

(Please correct the above as needed.)

4. 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:

Comments:

Problem

Resolution:

Cost Control:

Timeliness:

Business

Relations:

Customer

Service:

7. Total score:

U.S. Department of Education

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 and Acquisitions Management

PCP Room 7121

550 12th Street, SW

Washington, DC 20202

Or e-mail to: Joseph.Gibbs@ed.gov

Or fax to: 202-245-6297

Attn: Joseph Gibbs

RFP #: U.S. Participation in the

Progress in International Reading

Literacy Study (PIRLS) 2016

SOURCE SELECTION INFORMATION—SEE 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: N/A

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 contractor’s 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 contractor’s 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

0 - Unsatisfactory Nonconformance jeopardizes the achievement of contract goals; default.

1 - Poor Nonconformance requires major agency intervention to ensure achievement of contract goals; show cause or cure notices.

2 - Fair Quality meets specifications in most cases, however, some agency intervention required to ensure achievement of contract requirements.

3 - Good Quality meets specifications in all cases.

4 - Excellent Quality exceeds specifications in some cases.

Problem Resolution

0 - Unsatisfactory Inadequately resolved problems jeopardize contract goals.

1 - Poor Significant agency intervention required to resolve problems jeopardizing contract goals.

2 - Fair Some agency intervention required to resolve problems jeopardizing contract goals.

3 - Good Successfully overcomes or resolves all problems and achieves contract goals with minimal agency intervention.

4 - Excellent Anticipates and avoids most problems and successfully overcomes all unforeseen problems.

Cost Control

0 - Unsatisfactory Cost increases jeopardize achievement of contract goals; or billings routinely include unallowable costs.

1 - Poor Significant cost increases; or some inaccurate billings including some with unallowable costs.

2 - Fair Minor cost increases; or some inaccurate billings, but a minimal (1-2) number with unallowable costs.

3 - Good Contractor performed within costs; but some late billings, none with unallowable costs.

4 - Excellent Costs were less than the amount cited in the contract; and billings accurate and timely.

Timeliness of Performance 0 - Unsatisfactory Delays jeopardize the achievement of contract goals.

1 - Poor Other significant delays.

2 - Fair Minor delays.

3 - Good All deliverables on time.

4 - Excellent All deliverables on time with some ahead of schedule; or stays on schedule despite unforeseen circumstances.

Business Relations

0 - Unsatisfactory Unethical or illegal business practices.

1 - Poor Business practices are not attuned to customer support.

2 - Fair Business practices are somewhat attuned to customer support.

3 - Good Business practices focus on customer support.

4 - Excellent

Customer Service

Highly effective, proactive business practices focused on customer support.

0 - Unsatisfactory Response to service requests is routinely late, ineffective, or rude; customers express frustration or anger about many interactions; complaints are unresolved; contractor seems unaware of service issues.

1 - Poor Response to service requests is often late, ineffective or rude; some complaints are resolved.

2 -Fair Response to service requests is uneven in timing or effectiveness; customer interactions are tenuous; contractor is trying hard and understands service issues.

3 - Good Response to service requests is timely, effective and courteous; customers express positive feedback; delivery of service is smooth and organized; collects customer feedback; customer problems are resolved well.

4 - Excellent Response to service requests is timely, effective and courteous; the contractor is proactive in building good relations with customers, proposing new service strategies, analyzing and reporting on service loads and collecting and using customer feedback.