Attachment_C_Past_Performance_Questionnaire_HS0021-15-R-0006.pdf

Solicitation: HS0021-15-R-0006 Attachment C: Past Performance Questionnaire

The Defense Security Service (DSS) has a requirement for program support services, issued as Solicitation HS0021-15-R-0006. Your organization has been identified to provide a reference for the Contractor and contract action identified below. In accordance with Federal Acquisition Regulation (FAR) 42.15 – CONTRACTOR PERFORMANCE INFORMATION, past performance information is relevant information, for future source selection purposes, regarding a contractor’s actions under previously awarded contracts.

You are requested to complete this questionnaire and elaborate as much as possible when answering. Please provide any positive information, as well as information related to any problems, concerns, or other information you feel may be helpful in our evaluation of the contractors Past Performance.

Do not return this form to the Contractor. Submit the completed form directly to the Government Representative identified below, to arrive no later than May 7, 2015 at 2:00pm ET.

Please e-mail completed questionnaire to:

Attn: Shawna Mitchell, shawna.mitchell@dss.mil

Defense Security Service Office of Acquisitions 27130 Telegraph Road Quantico, VA 22134

Phone: (571) 305-6548

SECTION I - CONTRACTOR INFORMATON

(To Be Completed By Contractor)

1. Company Name & Address of Contractor

2. Contract Number 3. Contract Value

4. Contract Start Date 5. Contract Completion Date

6. Contract Type (Circle All That Apply): 7. Complexity of Work

1. FIXED PRICE

2. COST PLUS FIXED FEE

3. COST PLUS AWARD FEE

OTHER:________________________________

DIFFICULT ROUTINE

SECTION II - CUSTOMER INFORMATON

(To Be Completed By Customer)

1. Organization/Company Name and Address

2a. Name of Individual Completing Questionnaire 2b. Title

2c. Phone 2d. E-mail

Brief Description of Contract Requirements:

SECTION III – CONTRACTOR’S PERFORMANCE EVALUATION

Question 1. Was the contractor capable, efficient, and effective in completing the contract requirements?

Answer:_____________________________________________________________________________________________________

Question 2. Did the contractor comply with contract requirements, terms and conditions?

Answer:_____________________________________________________________________________________________________

Question 3. Was the contractor reasonable, cooperative, and committed to customer satisfaction?

Answer:_____________________________________________________________________________________________________

Question 4. Was the contractor successful in recruiting and retaining personnel necessary to perform the contract according to the statement of work?

Answer:_____________________________________________________________________________________________________

Question 5. Would you recommend and/or do business with this contractor in the future? Explain

Answer:_____________________________________________________________________________________________________

KEY

OUTSTANDING Offeror’s performance significantly exceeded most or all contract requirements.

Furthermore, the offer provided significant, unusual, unique, or worthwhile features or benefits and performance was of the highest quality.

BETTER Offer’s performance fully exceeds many of the contract requirements. Offeror’s performance has resulted in a high level of efficiency and productivity and quality

SATISFACTORY Offer’s performance met customer expectations or contract requirements.

MARGINAL Offeror’s performance was less than satisfactory and could have stood improvement.

Question 6. How would rate the contractor’s service?

Answer (Please circle one):

a. Outstanding b. Better c. Satisfactory d. Marginal

Question 7. How would you rate the contractor’s responsiveness?

Answer (Please circle one):

a. Outstanding b. Better c. Satisfactory d. Marginal