Past Performance Questionnaire.doc
DOC document 68 KB Posted
- Attached to
- Interpreting Services DFAS-Indianapolis Federal contract opportunity
- Solicitation number
- HQ0423-12-T-0002
- Issued by
- Defense Finance and Accounting Service
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Past Performance Questionnaire
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| File | Type | Posted |
|---|---|---|
| PerformanceWorkStmnt.pdf | ||
| Schedule of Items Table.doc | DOC document | |
| DFAS_Clauses.pdf | ||
| WD1998-0742.pdf |
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HQ0423-12-T-0002
Past Performance Questionnaire
Request for Quotes Number: HQ0423-12-T-0002 A quoter has provided this questionnaire to you (the Respondent) based upon previous work that they have accomplished for you. The company considers this to be relevant experience for the work involved in this solicitation. The Government will evaluate relevant past performance of each quoter in makings its award determination. This questionnaire is one way for the Government to obtain such information.
Please provide your candid responses. It is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by Government evaluators. However, the Government may contact you for follow-up information. If you do not have knowledge of or experience with the company in questions, please forward this questionnaire to the person who does or notify the Contract Specialist identified below immediately. Thank you.
PART I (To be completed by the Quoter as applicable) Contractor/Company Name/Division:
Contract Place of Performance (w /address):
| Contract Number: |
| Contract Award Amount: |
Prime Contract Name (if this was a subcontract effort):
| Contract Award Date: |
| Contract Completion Date: |
Brief Project Description:
Quoter’s Point of Contact For Respondent Questions:
Name/Title:
Telephone/Fax Number:
Email:
Date Sent to Respondent:
PART II – EVALUATION (To be completed by Respondent as applicable)
Section 1: Contact Information for the Individual Completing Survey:
| Name: |
| Functional Responsibility: |
| Organization: |
| Phone: |
| FAX: |
| E-Mail Address: |
Dates of Involvement:
From:
To:
Mailing Address:
Section 2: Contract Information:
Company Being Rated:
| Contract Number: |
| Award Date:: |
| Total Contract Value: |
Brief Description of Work Including Complexity of Work and period of performance:
FORMCHECKBOX
Complete FORMCHECKBOX Ongoing
Signature:
Date:
Section 3: Evaluation
Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:
| Code |
| Performance Level |
| O |
| Outstanding: the contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example to others. It is expected that this rating be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as Excellent. |
| E |
| Excellent: the contractor has substantially exceeded the contract performance requirements. |
| G |
| Good: There are no or very minimal issues and the contractor has met the contract requirements. |
| F |
| Fair: Overall compliance requires minor agency resources to ensure achievement of contract requirements. |
| P |
| Poor: Overall compliance requires significant agency resources to ensure achievement of contract requirements. |
| U |
| Unsatisfactory: non-conformances are jeaopardizing the achivement of contract requirements, despite use of agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements. |
| N |
| Not Applicable: unable to provide a score. |
1. Contractor’s ability to achieve a high level of customer satisfaction?
| O |
| E |
| G |
| F |
| P |
| U |
| N |
Comments:
2. Contractor’s ability to effectively schedule contract personnel and communicate schedule requirements in a timely fashion?
| O |
| E |
| G |
| F |
| P |
| U |
| N |
3. Contractor’s ability to maintain effective communications, professional conduct of business, and accurate invoicing with the customer organization?
| O |
| E |
| G |
| F |
| P |
| U |
| N |
4. Contractor’s Overall Contract Performance?
| O |
| E |
| G |
| F |
| P |
| U |
| N |
5. Please comment on any special recognition (positive or negative) that this Contractor or its personnel received for this contact:
Comments:
Section 4: Submission of Questionairre Completed questionnaires should be sent to Carrie Fairbanks via email: carrie.fairbanks@dfas.mil or fax: (614) 693-1808 by no later than 3:00 pm (EST) November 21, 2011.
Thank you for completing this questionnaire.
Your time and candor are greatly appreciated.
File details come from the government source that posted it. Updated .