Section E Attachment D Past Performance Questionnaire Amendment 0004.docx

Past Performance Questionnaire

Note: Completed questionnaires shall be considered confidential information and may not be seen or reviewed by the contractor/Offeror. Mail or email completed questionnaires directly to:

Attention: Amy Lineberry, Contracting Officer General Services Administration Denver Federal Center Bldg. 41, P.O. Box 25546 (8P2PQ) Denver, CO 80225-0548 amy.lineberry@gsa.gov Name:________________________________________________________________ Company:

Role/position:

Current Telephone No.:

(Use this cover sheet for each past performance questionnaire submitted)

USE THIS QUESTIONNAIRE FOR THE OFFERING COMPANY’S PAST PERFORMANCE

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

PUBLIC BUILDINGS SERVICE

ROCKY MOUNTAIN REGION

OVERVIEW

The Offeror shown below is submitting qualifications for the Administrative and Technical Support Service Contract for GSA, Region 8, and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday, March 22, 2011 2:30 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

SECTION 1: Contract Identification To be completed by the Offeror and provided to the customer referenced

Name of Offeror being evaluated: _______________________________________

Project Number/Title: _________________________________________________

Project Location:_____________________________________________________

Project Description: ___________________________________________________

Project Award Amount: $_______________________________________________

Project Final Dollar Amount: $___________________________________________

Year Completed: _________ Program Manager: _________________________

SECTION 2: Respondent Identification

Name of Evaluator: ________________________________________________ Relation to Contract/Project: ___________________________________________ Company Name: ____________________________________________________ Phone Number (Commercial/DSN): ____________________________________ Email Address: ____________________________________________________

SECTION 3: Rating of Offeror To be completed by the customer:

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Score Performance Level

5 EXCELLENT - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 VERY GOOD- The contractor’s performance meets or exceeds contractual requirements to the Government’s or customer’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 ACCEPTABLE – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appears, or were, satisfactory.

2 MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

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

N NOT APPLICABLE - Unable to provide a score.

Management Professional conduct

Cooperation/responsiveness –timely, solicits feedback, suggests alternatives

Offeror is easy to work with, friendly, courteous

Oversight of project management

Quickly/professionally resolves issues/disputes

Review/resolution of project issues

Appropriately awarded and monetarily recognized employees for accomplished work and/or exceeding expectations

Maintained continuity of contract employees over the term of the contract/project

To what extent did they adhere to the proposed staffing plan

To what extent did they minimize trunover

SECTION 4: Narrative Summary Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Weaknesses of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Additional Thoughts: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you hire this firm again? __________________________________________________________

USE THIS QUESTIONNAIRE FOR OFFERING COMPANY’S PAST PERFORMANCE

SECTION 5: Submission Thank you for taking the time to fill out this questionnaire. As stated above, when filled in this document is source selection sensitive information IAW FAR 3.104. When completed please mail, hand-deliver, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date:_______________

USE THIS QUESTIONNAIRE FOR THE PROGRAM MANAGER AND THE CONTRACT ADMINISTRATOR’S PAST PERFORMANCE

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

The Offeror shown below is submitting qualifications for the Program Manager and the Contract Administrator on the Administrative and Technical Support Services Contract for GSA, Region 8 and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday, March 22, 2011 2:30 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

Name of Offeror being evaluated: _______________________________________

Project Number/Title: _________________________________________________

Project Location:_____________________________________________________

Project Description: ___________________________________________________

Project Award Amount: $_______________________________________________

Year Completed: _________ Program Manager: __________________

Relation to Contract/Project: ___________________________________________ Company Name: ____________________________________________________ Phone Number (Commercial/DSN): ____________________________________

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Score Performance Level

5 EXCELLENT - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 VERY GOOD- The contractor’s performance meets or exceeds contractual requirements to the Government’s or customer’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 ACCEPTABLE – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appears, or were, satisfactory.

2 MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

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

N NOT APPLICABLE - Unable to provide a score.

Professional conduct

Cooperation/responsiveness –timely, solicits feedback, suggests alternatives

Offeror is easy to work with, friendly, courteous

Oversight of project management

Quickly/professionally resolves issues/disputes

To what extent were they in compliance with the Service Contract Act

To what extent were they able to successfully manage a telework program

Performance Submittals provided on time/schedule

Adequacy / Accuracy of submittals

Timeliness of response to comments

Quickly identifies issues for resolution

Closeout Submission of required documentation

Timeliness of submissions

Format of closeout documentation

Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Weaknesses of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Additional Thoughts: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you work with this individual again? _________________________________________________

USE THIS QUESTIONNAIRE FOR THE PROGRAM MANAGER AND CONTRACT ADMINISTRATOR’S PAST PERFORMANCE

SECTION 5: Submission Thank you for taking the time to fill out this questionnaire. As stated above, when filled in this document is source selection sensitive information IAW FAR 3.104. When completed please mail, hand-deliver, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date: _______________

USE THIS QUESTIONNAIRE FOR THE HUMAN RESOURCE MANAGER’S PAST PERFORMANCE

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

The Offeror shown below is submitting qualifications for the Human Resource Manager on the Administrative and Technical Support Services Contract for GSA, Region 8 and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday, March 22, 2011 2:30 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

Name of Offeror being evaluated: _______________________________________

Project Number/Title: _________________________________________________

Project Location:_____________________________________________________

Project Description: ___________________________________________________

Project Award Amount: $_______________________________________________

Year Completed: _________ Program Manager: __________________

Relation to Contract/Project: ___________________________________________ Company Name: ____________________________________________________ Phone Number (Commercial/DSN): ____________________________________

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Score Performance Level

5 EXCELLENT - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 VERY GOOD- The contractor’s performance meets or exceeds contractual requirements to the Government’s or customer’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 ACCEPTABLE – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appears, or were, satisfactory.

2 MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

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

N NOT APPLICABLE - Unable to provide a score.

Professional conduct

Cooperation/responsiveness –timely, solicits feedback, suggests alternatives

Offeror is easy to work with, friendly, courteous

Oversight of project management

Quickly/professionally resolves issues/disputes

Performance Demonstrate ability to effectively recruit and retain qualified staff

Demonstrate ability to maintain business relations

Timeliness of response to filling vacancies

Timeliness of employee performance issues for resolution

Closeout Submission of required documentation

Timeliness of submissions

Format of closeout documentation

Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Weaknesses of performance: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Additional Thoughts: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you work with this individual again? _________________________________________________

USE THIS QUESTIONNAIRE FOR THE HUMAN RESOURCE MANAGER’S PAST PERFORMANCE

SECTION 5: Submission Thank you for taking the time to fill out this questionnaire. As stated above, when filled in this document is source selection sensitive information IAW FAR 3.104. When completed please mail, hand-deliver, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date: _______________