Attachment 7a - Past Performance Questionnaire.doc

Attachment 6

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: HQ003425R0009 DSCA International Loan Modeling & Budget Management

OFFEROR INFORMATION

COMPANY NAME AND DIVISION NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):

TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID):

PRICING TYPE: (Check all that apply)

FP FPI CPFF CPAF CPIF IDIQ BOA

file_0.wmf file_1.wmf

Requirements Labor-Hour T&M Other (Specify)

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACTAMOUNT:

INITIALCONTRACTDOLLARVALUE(W/OPTIONS):

FINALCONTRACTDOLLAR VALUE(W/OPTIONS):

ROLE ON PROJECT: PRIME

SUBCONTRACTOR (EXPLAIN TYPEAND EXTENTOF SUBCONTRACTING, IF APPLICABLE): OTHER(EXPLAIN)

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

Attachment 8

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE (e.g. CO, COR, PM):

ADDRESS:

PHONE NUMBER:

FAX NUMBER:

E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A.

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-elementbeing evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Performance Element Exceptional Very Good Satisfactory Marginal Unsatisfactory

1. QUALITY OF PRODUCT OR SERVICE

Assess the contractor’s performance to contract requirements, specifications, and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).

Comments:

Performance Element

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

2. SCHEDULE

Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or affect the schedule).

3. COST CONTROL

Assess the contractor’s effectiveness in forecasting, managing, and controlling cost.* *Cost Control – not required for Firm Fixed Price (FFP). If FFP please extend N/A in the comments box.

4. BUSINESS RELATIONS

Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness, and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award, and management of subcontractors.

5. MANAGEMENT OF KEY PERSONNEL

Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

6. UTILIZATION OF SMALL BUSINESS

FAR Subpart 19.7 and 15 U.S.C. 637 containsstatutory requirements for complying with the Small Business subcontracting Program. Assess whether the contractor provided maximum practicable opportunity for small business to participate in contract performance consistent with efficient performance of the contract.* *Not required for Small Businesses.

7. Comments:

8. Additional comments you would like to share

Signature/Date