Past_Performance_Questionnaire.pdf

ATTACHMENT

Past Performance Rating – Solicitation GS-04P-15-EW-D-0141

Project Name: Combined (O&M and Janitorial) Services

PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Name:

Role on Project: (Prime/Subcontractor):

2. Contract Number:

3. Contractor Address: 4. Contract Type:

____Firm Fixed Price

____T&M/LH

____Cost Reimbursement ____Other (Please Specify)

5. Agency/Company Name: 6. Agency/Company POC/Phone/Email

7. Period of Performance:

8. Dollar Amount of Award: $______________

Annual Amount: $______________ Total Dollar Value with Mods:$_____________

9. Title of Contract:

10. Description of Contract Service/Scope of Contract:

11. Complexity of Work: Difficult: ____________ Routine: ____________

NOTE: Please use adjectival ratings from attached sheet.

12. Evaluation Factor 13. Comments (Attach additional sheets, if necessary.) 14. Rating

a. Quality of Work

COMMENTS ARE HIGHLY ENCOURAGED/

MANDATORY FOR RATING OF EXCEPTIONAL &

UNSATIFACTORY

b. Personnel

MANDATORY FOR RATING OF EXCEPTIONAL&

c. Cost/Budget Control

d. Customer Satisfaction

MANDATORY FOR RATING OF “5” or “0”

1-5

e. Timeliness of Performance/Deliverables

COMMENTS ARE HIGHLY ENCOURAGED/

MANDATORY RATING OF EXCEPTIONAL &

f. Business Relations

g. Overall Performance COMMENTS ARE MANDATORY FOR OVERALL

RATING OF EXCEPTIONAL & UNSATIFACTORY

15. Would you select this contractor again? Please explain. (Attach additional sheet if necessary.)

16. Name & Date: 17. Title:

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Marginal, Satisfactory, Very Good, and Exceptional. Use the following instructions as guidance in making these evaluations. Please use the comments area on the preceding form to justify the rating given.

Ratings Quality of Work/

Personnel/Service

-Compliance w/contract requirements -Accuracy of reports -Appropriateness of personnel -Technical excellence

Cost/Budget Control

-Within budget -Current, accurate, complete billings -Relationship of negotiated costs to actual

Customer Satisfaction

Customer Satisfaction is a measure of how products and services supplied by a company meet or surpass customer expectation.

On a scale of 1-5 (5 being the

Timeliness of Services/Deliver ables

-Met interim milestones -Reliable -Responsive to technical direction -Completed on time

Business Relations

-Effective Mgmt -Business like correspondence -Responsive to contract reqmnts -Prompt notification of problems -Reasonable/ cooperative -Flexible -Pro-active

-Cost efficiencies -Change orders issued highest) please rate and describe your level of satisfaction with the contractor’s performance.

5 - Very satisfied

4 - Somewhat satisfied

3 - Neither satisfied nor dissatisfied

2 -Somewhat

0 - Very

Unsatisfactory Nonconformances are comprising the achievement of contract reqmnts

Cost issues are comprising performance

Delays are compromising achievement of contract reqmts

Response is not effective

Marginal Nonconformances require major agency resources to ensure achievement of contract reqmnts

Cost issues require major agency resources to ensure achievement of contract reqmnts

Delays require major agency resources to ensure achievement of contract reqmnts

Response is marginally effective

Satisfactory Nonconformances do not impact achievement of contract reqmnts

Cost issues do not impact achievement of contract reqmnts

Delays do not impact achievement of contract reqmnts

Response is usually effective

Very Good There are no quality problems/issues, and the contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government

There are no cost management issues and the Contractor has exceeded the contract requirements, achieving cost savings to the Government.

There are no delays

Response to inquiries and/or technical, service, administrative issues are effective.

The contractor has The contractor The contractor The contractor

Exceptional demonstrated an exceptional performance level that was significantly in excess of anticipated achievements and is commendable as an example for others.

It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".

has demonstrated an exceptional performance.

It is expected that this rating will be used in those rare circumstances where the contractor achieved cost savings and performance clearly exceeds the performance levels described as "Exceptional".

has demonstrated an exceptional performance level. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".

has demonstrated an exceptional performance level. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".