ATTACHMENT 7 -Past Performance Survey REVSIED

RFP# HHS-NIH-DA-12-242

Attachment 7 - REVISED Past Performance Survey New Experimental Medicine Studies: Fast-Fail Trials in Psychotic Spectrum Disorders (FAST-PS) March 23, 2012

(SAMPLE) REQUEST FOR PAST PERFORMANCE INFORMATION TO BE SENT TO

OFFEROR’S CLIENTS

Date:

Dear Client:

We are currently responding to the DHHS/NIH/NIMH RFP: HHS-NIH-DA-12-242 entitled:

“New Experimental Medicine Studies: Fast-Fail Trials in Psychotic Spectrum Disorders (FAST-PS).” The Government is placing increased emphasis in their procurements on past performance as a source selection factor and is requiring that clients of firms responding to NIMH solicitations be identified and their participation in the evaluation process be requested.

Therefore, enclosed is a past performance questionnaire for your completion. We are requesting that you complete the questionnaire and return it to the following Contracts Management Office by March 29, 2012

, as this information must be submitted no later than the due date of the proposal.

We thank you for your prompt response in this matter.

Sincerely, (To be signed by offeror)

Attachment

(Either E-mail, mail, or Fax to:

jacobsonmj@mail.nih.gov

Marla Jacobson, Contract Specialist National Institute of Mental Health (NIMH) Contracts Section R&D Contracts Management Branch NIDA Neuroscience COAC 6001 Executive Blvd., Rm. 8154 (MSC 9661) Bethesda, MD 20892 mailto:jacobsonmj@mail.nih.gov�

Past Performance Survey

PAST PERFORMANCE INFORMATION

NATIONAL INSTITUTES OF HEALTH CUSTOMER SURVEY OF CONTRACTOR

PERFORMANCE

Please complete the following questionnaire and return via regular mail, E-mail, or fax to the attention of:

To: Marla Jacobson, Contract Specialist By: March 29, 2012 jacobsonmj@mail.nih.gov (E-Mail Address)

301-443-6893 (Fax Number)

This survey pertains to: (Name of Company/Organization)

Department/Component: _________________________________________________________

Contract Number: _________________________ Date of Survey: ____________________

Name of Person Completing Survey: ________________________________________________

Signature of Person Completing Survey: _____________________________________________

Your Company/Agency: ___________________________________________________________

Your Role in this Contract (circle one): Contracting Officer Contract Specialist Project Officer Other ________________________

Contract Value (including options) : $ ________________________________________________

Period of Performance ( including option periods) : _____________________________________

Type of Contract: (e.g., cost reimbursement, fixed price, etc.)

General description of products / services required under the contract:

Approximate percentage of work being performed (or completed) by subcontractor (s) :_________% mailto:Marla.jacobson@nih.gov�

Past Performance Survey

NATIONAL INSTITUTES OF HEALTH CUSTOMER SURVEY OF CONTRACTOR PERFORMANCE

Information on subcontractor(s) (where more than _______ % of work was completed by the subcontractor):

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Commentary to support rating may be noted on page 5.

Assign each area a rating of 0 (unsatisfactory) , 1 (Poor) , 2 (Fair) , 3 ( Good) , 4 (Excellent) , or 5 (Outstanding) .

Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the contractor to make a determination on any of the performance criteria below, please circle “N/A” (not applicable / no opinion).

QUALITY OF SERVICE

1. Compliance with contract requirements 0 1 2 3 4 5 N/A

2. Accuracy of reports 0 1 2 3 4 5 N/A

3. Effectiveness of personnel 0 1 2 3 4 5 N/A

4. Technical Excellence 0 1 2 3 4 5 N/A

COST CONTROL

1. Record of forecasting and controlling target costs 0 1 2 3 4 5 N/A

2. Current, accurate and complete billings

Past Performance Survey

3. Relationship of negotiated costs to actuals

4. Cost efficiencies

TIMELINESS OF PERFORMANCE

1. Met interim milestones 0 1 2 3 4 5 N/A

2. Reliability 0 1 2 3 4 5 N/A

3. Responsive to technical directions 0 1 2 3 4 5 N/A

4. Completed on time including wrap-up and contract administration 0 1 2 3 4 5 N/A

5. Met delivery schedules 0 1 2 3 4 5 N/A

6. Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS

1. Effective management, including management of subcontracts 0 1 2 3 4 5 N/A

2. Reasonable/cooperative behavior 0 1 2 3 4 5 N/A

3. Responsive to contract requirements 0 1 2 3 4 5 N/A

4. Notification of problems 0 1 2 3 4 5 N/A

5. Flexibility 0 1 2 3 4 5 N/A

6. Pro-active vs reactive 0 1 2 3 4 5 N/A

CUSTOMER SATISFACTION

1. The contractor is committed to customer satisfaction.

Yes No (circle one)

2. Would you recommend selection of this firm again?

Yes No (circle one)

Past Performance Survey

ADDITIONAL COMMENTS REGARDING CLIENT’S PERFORMANCE:

NATIONAL INSTITUTES OF HEALTH CUSTOMER SURVEY OF CONTRACTOR PERFORMANCE

QUALITY OF PRODUCT

OR SERVICE

COST CONTROL TIMELINESS OF

PERFORMANCE

BUSINESS

RELATIONS

0-

UNSATISFACTORY

Contractor is not in compliance and is jeopardizing achievement of contract objectives

Contractor is unable to manage costs effectively

Contractor delays are jeopardizing performance of contract objectives

Response to inquiries, technical/ service/ administrative issues is not effective 1-Poor Major problems have been encountered Contractor is having major difficulty in managing costs effectively

Contractor is having major difficulty meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is marginally effective

2-Fair Some problems have been encountered

Contractor is having some problems in managing costs effectively

Contractor is having some problems meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is somewhat effective

3-Good Minor inefficiencies/ errors have been identified Contractor is usually effective in managing costs

Contractor is usually effective in meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is usually effective

4-Excellent Contractor is in compliance with contract requirements and/ or delivers quality products / services

Contractor is effective in managing costs and submits current, accurate, and complete billings

Contractor is effective in meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is effective

5-Outstanding: The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as “Excellent.”

We are currently responding to the DHHS/NIH/NIMH RFP: HHS-NIH-DA-12-242 entitled: “New Experimental Medicine Studies: Fast-Fail Trials in Psychotic Spectrum Disorders (FAST-PS).” The Government is placing increased emphasis in their procurements on...