MSC Past Performance Questionnaire2.19.10.doc

PAST PERFORMANCE QUESTIONNAIRE

Mobile Surveillance Capability Procurement Please complete questionnaire and email to MSC@dhs.gov.

I.

Evaluation of Offeror:

Company/Division Providing Services: ________________________________________

II.

Evaluated by:

Company/Organization/Address: _____________________________________________

Name & Title: ___________________________________________________________

Telephone: ______________________________________________________________

III.

Evaluation:

Please answer questions 1 through 4 using the following criteria. Circle only one response per question. For elements rated “unsatisfactory”, please comment on the specific problem(s) or performance failure(s) that prompted this rating. For elements rated “exceptional”, please comment on the specific performance that exceeded contractual requirements.

4 – Exceptional: Performance met and exceeded many of the contractual requirements to the organization’s benefit. The contractual performance of the element being evaluated was accomplished with few minor problems for which corrective actions were highly effective.

3 – Very Good: Performance met and exceeded some of the contractual requirements to the organization’s benefit. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were effective.

2 – Satisfactory: Performance met contractual requirements. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were satisfactory.

1 – Marginal: Performance barely met contractual requirements. The contractual performance of the element being evaluated reflects a serious problem for which corrective actions have not yet been identified, appear only marginally effective or were not fully implemented.

0 – Unsatisfactory: Performance did not meet some contractual requirement and recovery is not likely in a timely manner. The contractual performance of the element being evaluated reflects serious problems for which corrective actions were ineffective.

N/A: Not applicable or not observed.

1) Evaluate the offeror’s overall performance:

N/A

Comments:

2) Evaluate the offeror’s commitment to customer relationships (satisfaction, cooperation):

N/A

Comments:

3) Evaluate the offeror’s performance regarding delivering products and/or services that conform to or exceed contract requirements (quality/performance, schedule, cost/price):

N/A

Comments:

4) Evaluate the offeror’s leadership and/or managerial impacts with respect to dealing with changed circumstances respective of the origin of those changed circumstances:

N/A

Comments: