Attachment 1 - Past Perf Questionaire SPED Heidelberg.docx

HE1280-11-R-0001 Attachment 1

Past Performance Questionnaire DEPARTMENT of DEFENSE DEPENDENTS SCHOOLS (DoDDS) EUROPE Heidelberg District Special Education Student Transportation Services

Instructions to Offerors: Offerors shall complete Blocks 1 through 5 below and send this Questionnaire to the corresponding references for each contract and subcontract identified in the listing submitted with the Past Performance Proposal. It is strongly recommended that offerors coordinate closely with references receiving this form, both private industry and government alike, to ensure correct and sufficient completion and submission to the offeror prior to the proposal due date. Specific instructions for submission of the completed evaluation form by the reference to the Government are provided on Page 2.

Block 1

Name of Reference (Business Name or Contracting Activity):

Block 2

Contract Number:

Block 3

Contract Type:

Block 4

Contract Period of Performance:

Block 5

Total Contract Value (including options):

Block 6

Description of Services or Supplies:

Instructions to Recipient References: References should complete Blocks 6 through 10 below and return the completed form to the attention of Gina Romano, Contract Specialist, gina.romano@eu.dodea.edu and Bernadette Honish, Contracting Officer, Bernadette.Honish@eu.dodea.edu. It is imperative that persons completing this form provide clear, concise and sufficient written narrative to adequately support the ratings they have assigned; and to submit the completed form prior to the proposal due date. If more space is needed to complete a written narrative, please attach additional pages as necessary. Definitions for the rating standards (e.g., Exceptional, Very Good, Satisfactory, etc.) are provided on Page 4.

Block 6

Quality of Service Rating ____________________ Written Narrative to Support Rating:

Block 7

Timeliness of Performance Rating ____________________

Block 8

Cost Control Rating ____________________

Block 9

Business Relations Rating ____________________

Past Performance Rating Standards (Adjectival) Exceptional - The company has demonstrated an exceptional record of performance and has provided or continues to provide services with the highest standard of quality at very low to no risk to the Government.

Very Good - The company has demonstrated a very good record of performance and has provided or continues to provide services with a high standard of quality at low risk to the Government.

Satisfactory - The company has demonstrated a satisfactory record of performance and has provided or continues to provide services with a satisfactory standard of quality at moderate risk to the Government.

Unacceptable - The company has demonstrated an unacceptable record of performance and has provided or continues to provide services with an unacceptable standard of quality at high risk to the Government.

Neutral - The company has no record of past performance or for whom information on relevant past performance is not available.

Performance Factor Rating Definitions