Atch L-5 PP Performance Questionnaire.rtf

RFP FA6643-10-R-0003

Attachment L-5

SOURCE SELECTION INFORMATION – See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be accurate:

Contractor’s Name: __________________ Address: __________________________

Telephone Number: ____________________ Fax Number: _________________________ Point of Contact: ______________________

(The government enters the following information based on list of references provided by the offeror. The offeror will enter this information if the solicitation requires him to submit questionnaires to the references.)

Project Title and Brief Description of Work: ____________________________________* Contract Number Provided by Offeror: ___________________ Dollar Amount: _______* Contract Period or Dates of Performance Provided by Offeror: ________________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

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

B. RESPONDENT INFORMATION:

Name of Respondent:_________________ Title: ______________________________ Address: ___________________________ Telephone Number: ___________________ Fax Number:_________________________ Email Address: _______________________

C. FAX/EMAIL COMPLETED SURVEY FORM TO:

Susan Forchette 478-327-2210/susan.forchette@us.af.mil

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. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E - Exceptional Performance meets contractual requirements with many Eeeded 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.

G - Good Performance meets contractual requirements with some Eeeded 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.

S - Satisfactory 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 satisfactory.

M - Marginal 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.

U - Unsatisfactory 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.

N - Neutral Performance was not observed or not applicable to the current effort being reported against.

1. PROGRAM MANAGEMENT

a. Ability to grasp/respond to your advertising needs E G S N M U

b. Problem solving ability E G S N M U

c. Ability to understand changing Market conditions E G S N M U

d. Use of research in program development E G S N M U

e. Ability to develop a strategic plan E G S N M U

f. Long term thinking ability E G S N M U

g. Ability to develop single campaign with E G S N M U multiple objectives

h. Integration of all advertising campaigns E G S N M U

i. Ability to accurately identify target audiences E G S N M U

j. Ability to develop effective advertising campaigns E G S N M U

k. Ability to develop effective media plans/schedules E G S N M U

l. Ability to provide fresh ideas E G S N M U

m. Ability to build public support for company E G S N M U

n. Success in achieving your advertising needs E G S N M U

2. PERSONNEL

a. Retention of employees and key personnel E G S N M U

b. Subcontractor’s quality of work E G S N M U

c. Experience, talent and skills of key personnel E G S N M U

d. Ability of staff to produce on-strategy work E G S N M U

e. Involvement of top agency management E G S N M U

COMMENTS: _____________________________________________________________________

3. TIMELINES

your company’s advertising program

c. Contractor’s timely submission of reports E G S N M U

d. Agency’s response to modification requests E G S N M U

COMMENTS: _____________________________________________________________________

4. COST CONTROL

a. Overall rating of agency’s cost consciousness E G S N M U

b. Good stewardship of your ad budget E G S N M U

c. Agency’s effectiveness in reducing costs E G S N M U

e. Agency’s invoices are current and accurate E G S N M U

f. Agency’s financial stability E G S N M U

COMMENTS: ______________________________________________________________________

5. BUSINESS RELATIONS

a. Personality and chemistry of agency staff E G S N M U

b. Cooperation in resolving problems E G S N M U

c. Working relationship with agency personnel E G S N M U

d. Working relationship with contracting officer E G S N M U

e. Relationship with subcontractors E G S N M U f Tenacity and innovations in resolving problems E G S N M U

COMMENTS: ______________________________________________________________________

OVERALL AGENCY RATING E G S N M U

COMMENTS: ______________________________________________________________________

E. RESPONDENT INFORMATION

a. Name of evaluator: ___________________________

b. Phone/Office Symbol: _________________________

c. Position Title: ________________________________

d. Length of Involvement in Program/Contract: _________

e. Date Questionnaire completed: ___________________