Attachment 5 - Past Performance Questionnaire.docx

Questionnaire for Solicitation No. FA3047-10-R-0009 Attachment 5

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

For Postal/Mail Services A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: _________________ Telephone Number: ____________________ Address: _________________________ Fax Number: _________________________ _________________________ Point of Contact: ______________________

Contract Number: ___________________ Total Value of Contract:$________________________ Starting Date of Contract: ______________________ Ending Date of Contract:_______________ Project Title and Brief Description of Work: __________________________________________ Provide detailed information on last page in the “Remarks” section.

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds/has held other contracts with your organization within the last 3 years, complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ___________________________

Did contract performance include the following:

3. Was monthly mail volume 200,000 pieces Yes: _____No: _____ If yes, monthly quantity:___________

4. Was individual monthly mail service provided to 8,000 Yes: _____No: _____ If yes, monthly quantity_____________________

At how many locations?_________________________

C. FAX COMPLETED SURVEY FORM TO: Shirley J. Jones or current contracting officer , fax #: 210-671-1199 by NOT LATER THAN MAY 4, 2010.

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation.

Exceptional (E) – Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective Good (G) – Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory (S) – Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were effective.

Marginal (M) – Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory(U) – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Not Applicable (NA) PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M (marginal) or Unsatisfactory.

Performance:

1.a. Receiving mail E V S M U N/A

1.b. Sorting mail E V S M U N/A

1.c. Delivering mail E V S M U N/A

1.d. Weighing mail E V S M U N/A

1.e. Affixing postage E V S M U N/A

1.f. Courier service E V S M U N/A

2. Contractor’s management of mail volume E V S M U N/A

3. Contractor’s management of boxes or parcel E V S M U N/A

4. Mail service to individual customers E V S M U N/A

5. Overall quality of service for all locations served. E V S M U N/A

6. Overall mail room operations (customer service, organization, timely execution of duties) E V S M U N/A

Compliance and Other Issues

9. Conformance with customer service requirements and

Comments:

TIMELINESS

16. Successfully responded to emergency/unanticipated situations and requirements requiring staffing changes ……. E V S M U N/A

Comments:

BUSINESS RELATIONS

Comments:

CUSTOMER SATISFACTION

Comments:

Would you have any reservations about soliciting this contractor in the future?

Please provide your remarks for marginal or unsatisfactory ratings or any additional comments concerning this contractor’s performance, as desired.

WE APPRECIATE YOUR COOPERATION IN COMPLETING THIS QUESTIONNAIRE!