PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

Solicitation Ref No. HQ0029-2297-0001-000

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name/Signature and Role Relative to Contract (e.g. Buyer, Program Manager, etc.):

Agency or Business: ______________________________________________________

Address: ________________________________________________________________

Telephone No. _________________________ Fax No. _______________________

Return your completed questionnaire either electronically, by fax ____________________ or by Email at ___________________________.

PART I. SPECIFIC PROGRAM INFORMATION.

Contractor/Offeror: ___________________________________ CAGE Code: _________

Program Title and Brief Description:

Role in the Program/Work performed as: ____ Prime ____ Subcontractor ____Vendor/Supplier

Contract Number: _____________________ No. of Years? Basic: _____ Option: ______

Contract Type(s): _____________________________________________________________

PART II. GENERAL PROGRAM INFORMATION.

Period of Performance:

1. Original Schedule (assuming all options exercised): Start Date ______ through ________

2. Current Schedule (assuming all options exercised): Start Date ______ through ________

3. Reason for difference (if applicable)

Contract Dollar Value:

1. Original MAX Contract $ Value (assuming all options exercised): __________________

2. Current MAX $ Value (assuming all options exercised): __________________________

3. Primary Causes of Changes: _________________________________________________

NOTE: In Part III, should your response be other than “satisfactory”, please provide supporting documentation in “Additional Remarks”.

PART III. PERFORMANCE ASSESSMENT. Please check the appropriate rating for each of the following questions:

N/A=Not Applicable U-Unsatisfactory M=Marginal S=Satisfactory V=Very Good E=Exceptional

N/A U M S V E

1. Has the Offeror performed on larger projects requiring work and handling with analog media (such as film, video and still); if so, how well did they perform?

2. What is the Offeror’s past performance in providing digital delivery of media utilizing on-line and other delivery methods, and how well they have performed this task?

3. What is their past performance in mass digitization of large volumes (i.e., over 100,000 media items)?

4. Did the Offeror perform as expected?

5. Rate the Offeror’s record in managing multiple and diverse projects/tasks from planning through execution.

6. Rate the Offeror’s responsiveness to changing requirements.

7. Rate the Offeror’s effectiveness in handling priorities, changes and other unexpected situations.

8. Would you want to do business with them again?

9. Rate the Offeror technical competency.

10. Did they meet your delivery schedule?

PAST PERFORMANCE QUESTIONNAIRE

ASSESSMENT RATING SYSTEM

Solicitation Ref No. HQ0029-2297-0001-000

EXCEPTIONAL (E): Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD (V): Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY (S): Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL (M): Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear/were only marginally effective or were not fully implemented.

UNSATISFACTORY (U): Performance does/did not meet most contractual requirements and recovery is/was not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

NOT APPLICABLE (N/A) : Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

NOTICE TO QUESTIONNAIRE RESPONDENTS: Please do not include this page when returning the completed questionnaire.