Past_Performance_Form.docx

Past Performance Part I: RFQ HE1254-16-T-0010 CCMSE Training

Information Below To Be Completed by Vendor for a Minimum of Three References

Name of Agency/Command/Company Contracting Activity:

Contract number: Contract type:

Total contract value (Include exercised and unexercised options) At time of award: $ Currently (or at completion): $

Period of performance or delivery schedule (Include exercised an unexercised options) At time of award:

Currently (or at completion):

Brief description or title of contract requirements. Use space as needed, but do not exceed one typewritten page per contract.

Procuring Contracting Officer (PCO) Use current name as point of contact for on-going contracts or the last individual’s name for completed contracts.

Name:

Telephone number:

Facsimile number:

E-mail address:

Contracting Officer’s Representative (COR) Name:

Telephone number:

Facsimile number:

E-mail address:

Administrative Contracting Officer (ACO):

Name:

Telephone number:

Facsimile number:

E-mail address:

Brief description of any problems encountered and corrective actions taken to resolve those problems. Use space as needed, but do not exceed one typewritten page per contract.

Past Performance Part II: Questionnaire

RFQ: HE1254-16-T-0010 CCMSE Training

** Information to be completed by vendor’s references and emailed directly to DoDEA Procurement to samra.yoseph@hq.dodea.edu and jessie.garcia@hq.dodea.edu by March 7, 2016 at 10:00 A.M EST with subject, “Questionnaire CCMSE Training.”

REFERENCE INQUIRY

Name of Vendor: ____________________________________________________________________

1. Reference Firm Contacted

2. Project Title: __________________________________________________________________________

3. Contract Number (if known):

4. Name of Key Person Contact:

5. Key Contact Phone No.:

6. Did the Key Contact work directly on the contract referenced? Yes [ ] No [ ]

7. Contract period: From to

8. Brief Description of Work Performed: Please include whether the Contractor (i) provided interactive training specializing in conflict management in special education and (ii) modelled the use of conflict management skills in the special education context:

9. Quality of training and materials or resources used: Please briefly describe how effective the training was and materials or resurces used such as if CADRE-developed resources relevant to conflict management special education is used, Power Point slides, handouts, and other materials provided by the contractor personnel.

1. Degree of Cooperation by Contractor and Your Organization.

(a) How well overall did the Contractor work with the Contracting Organization?

1. Timeliness of Contract Work.

(a) Was work completed on time?

(b) Were there any unresolved problems during performance or afterwards? ____________

13. Would you recommend the Contractor? Yes No If no explain why

Rating __________________ (Excellent, Satisfactory or Unsatisfactory) Supporting Comments:

Common DoD Assessment Rating System

Excellent (E) - Performance meets contractual requirements and exceeds many to the Government's benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly 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 appear or were satisfactory.

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 serious problem(s) for which the contractor's corrective actions appear or were ineffective.

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