St. Es USCG DB Questionnaires.doc
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- GS11P09MKC0051
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Questionnaires
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ATTACHMENT 1: ORGANIZATION’S PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and mail or send by facsimile [FAX (202401-6075] to:
Bonnie Echoles, Contracting Officer
GSA, NCR, ROB (WPP)
301 7th Streets, SW; Room 7719 Washington, DC 20407
Desired Response Date:
May 11, 2009
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY D-B CONTRACTOR OFFEROR for U.S. CENSUS BUREAU PROJECT
| 1. CONTRACTOR’S (DBC MEMBER’S) NAME & ADDRESS: |
| 4. CONTRACT NO.: |
5. CONTRACT INITIATION DATE:
6. COMPLETION DATE:
2. OWNER’S NAME AND ADDRESS
7. CONTRACT VALUE $
8. TYPE OF CONTRACT:
3. PROJECT NAME
9. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:
Please add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
10. EVALUATION: :
a. EVALUATOR'S NAME, POSITION DURING PROJECT EXECUTION ( Project Manager/ COR/ Other) AND ORGANIZATION
b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic that best reflects your experience with this Contractor.
EX = Exceptional VG = Very Good
S = Satisfactory MG = Marginal
US = Unsatisfactory N/O = Not Observed
A. Quality of Products and Services - Assess the Contractor’s conformance to contract requirements.
EX
VG
S
MG
US
N/O
B. Overall Performance – Assess the Contractor’s overall performance as the General Contractor or Architect/Engineer (as appropriate) for the project.
S
MG
US
C. Schedule – Assess the timeliness of the Contractor against the design or construction schedule of activities (as appropriate).
S
MG
US
D. Technical Requirements – Assess the Contractor’s ability and capacity to fulfill the technical requirements of the contract.
S
MG
US
E. Cost Control – Assess the Contractor’s willingness and ability to manage the contract budget and control costs.
S
MG
US
F. Customer Satisfaction – Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
S
MG
US
G. Customer Satisfaction – Assess the Contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.
S
MG
US
H. Repeat Business -- Assess the likelihood that you would want this contractor to perform another contract for you in the near future.
S
MG
US
N/O
I. List Contractor’s Weak Points:
J. List the Contractor’s Strong Points:
K. List any other projects this contractor has completed for you:
If an Award Fee contract, what was the average Award Fee % earned?
ATTACHMENT 1: ORGANIZATION'S PERFORMANCE QUESTIONNAIRE
CONTINUATION SHEET
ATTACHMENT 2: INDIVIDUAL’S PERFORMANCE QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and mail or send by facsimile [FAX (202)401-6075] to:
Bonnie Echoles, Contracting Officer
GSA, NCR, ROB (WPP)
301 7th Streets, SW; Room 7719 Washington, DC 20407
Desired Response Date:
May 11, 2009
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
TO BE COMPLETED BY D-B CONTRACTOR OFFEROR for U.S. CENSUS BUREAU PROJECT
| 1. INDIVIDUAL’S NAME, COMPANY & DBC NAME: |
| 4. CONTRACT NO.: |
5. CONTRACT INITIATION DATE:
6. COMPLETION DATE:
2. OWNER’S NAME AND ADDRESS
7. CONTRACT VALUE $
8. TYPE OF CONTRACT:
3. PROJECT NAME
9. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:
Please add a continuation page if additional space is necessary.
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
10. EVALUATION: a. EVALUATOR'S NAME, POSITION DURING PROJECT EXECUTION ( Project Manager/ COR/ Other) AND ORGANIZATION:
b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:
Please circle the response code for each topic that best reflects your experience with this Individual.
EX = Exceptional VG = Very Good
S = Satisfactory MG = Marginal
US = Unsatisfactory N/O = Not Observed
A. Quality of Products and Services - Assess the Individual’s performance in assuring conformance to contract requirements.
S
MG
US
B. Overall Performance – Assess the Individual’s overall performance on the project.
S
MG
US
C. Initiative – Assess the Individual’s use of initiative to avoid problems and to respond to problems.
S
MG
US
D. Technical Requirements – Assess the Individual’s knowledge and ability to fulfill the technical requirements of the contract.
S
MG
US
E. Cost Control – Assess the Individual’s ability and willingness to manage the contract budget and control costs.
S
MG
US
F. Customer Satisfaction – Assess the Individual’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
S
MG
US
N/O
G. Customer Satisfaction – Assess the Individual’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED difficulties.
EX
VG
S
MG
US
H. Repeat Business – Assess the likelihood you would be willing to have this Individual work on another of your projects in the future.
S
MG
US
If an Award Fee contract, what was the average Award Fee % earned?
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