Past_Performance_Questionnaire.docx
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- Preventative Maintenance and Repair Program for the Northwest Region Federal contract opportunity
- Solicitation number
- HSBP1016R00400
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Past Performance Questionnaire
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PAST PERFORMANCE QUESTIONNAIRE
PART ONE: INSTRUCTIONS
The company who has provided you with this form is proposing on a Department of Homeland Security, Customs and Border Protection solicitation. Past Performance is an important part of the evaluation criteria for this acquisition, so your input is very important. Please provide an honest assessment and return the questionnaire in a sealed envelope to the requestor.
PART TWO: GENERAL INFORMATION
1. OFFEROR’S NAME AND ADDRESS 2. CUSTOMER ORGANIZATION
3. CONTRACT NUMBER: 2a. EVALUATOR
4. CONTRACT VALUE: $______________________ NAME:
TITLE:
PHONE NO:
| 5. CONTRACT AWARD DATE: | 6. CONTRACT COMPLETION DATE: | |
| _____/_____/_____ | _____/____/_____ |
7. CONTRACT TYPE: 8. COMPLEXITY OF WORK (Circle One Response):
DIFFICULT ROUTINE
9. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:
PART THREE: OFFEROR PERFORMANCE RATING
On the following pages, please summarize the offeror’s performance in each rating factors. Each factor has a set of sub-factors with four possible adjectival ratings. Determine the adjectival rating that most nearly represents experience with this offeror and indicate assessment by placing an “X” under the appropriate heading. Offeror performance factors are:
| A. QUALITY OF SERVICES/REPORTS |
| B. PROJECT MANAGEMENT - RESOURCE ALLOCATION |
| C. TIMELINESS OF PERFORMANCE |
| D. COST EFFECTIVENESS |
Adjectival ratings are defined below and should be used as a reference in assessing performance:
| EXCEPTIONAL |
| Offer’s performance met all contract requirements and exceeded many to the customer’s benefit. Offeror’s performance has resulted in a high level of efficiency, productivity and quality. Very little risk anticipated with performance or lack of customer satisfaction. |
| SATISFACTORY |
| Offer’s performance met customer expectations or contract requirements. Some potential risk and lack of customer satisfaction is anticipated based upon the offeror’s past performance. |
| UNSATISFACTORY |
| Performance did not meet most (or all) contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. |
| NEUTRAL |
| No relevant past performance record is available for evaluation. |
CBP Source Selection Process Overview Handout 4
| A |
| QUALITY OF SERVICE |
| Exceptional |
| Satisfactory |
| Unsatisfactory |
| Neutral |
| 1 |
| How was the overall value of services provided? |
| 2 |
| Did the contractor provide quality reports and documentation (i.e., accurate, current and complete)? |
| B |
| PROJECT MANAGEMENT |
| Exceptional |
| Satisfactory |
| Unsatisfactory |
| Neutral |
| 1 |
| Did the contractor provide effective contract and project management? |
| 2 |
| Was the contractor able to solve contract performance problems without extensive guidance from counterparts? |
| 3 |
| Did the contractor supply adequate and qualified replacement personnel? |
| 4 |
| How effective has the contractor been in understanding and responding to user requirements? |
| 5 |
| Did the contractor establish and maintain effective quality control standards and procedures? |
C
| TIMELINESS OF PERFORMANCE |
| Exceptional |
| Satisfactory |
| Unsatisfactory |
| Neutral |
| 1 |
| Did the contractor adhere to contract delivery schedules in the following areas: |
(a) performance of services?
(b) delivery of goods?
(c) delivery of reports or other documentation?
| 2 |
| Were replacement personnel identified and assigned to the project in a timely manner? |
D
| COST EFFECTIVENESS |
| Exceptional |
| Satisfactory |
| Unsatisfactory |
| Neutral |
| 1 |
| To what extent did the contractor meet the cost estimate? |
| 2 |
| Did the contractor effectively plan work to ensure maximum effective utilization of resources? |
PART THREE: OFFEROR PERFORMANCE RATING CONTINUED
1. Has this contract been partially or completely terminated for default or convenience?
| YES | Default | Convenience |
| NO |
If yes, please explain (e.g. inability to meet cost, performance, or delivery schedules - also include contract number, name, address, and phone number of Terminating Contracting Officer - TCO).
2. What was the contractor’s greatest strength in the performance of the contract?
3. What was the contractor’s greatest weakness in the performance of the contract?
4. Would you award another contract to this contractor?
YES No
COMMENTS:
PART FOUR: EVALUATOR’S CERTIFICATION
I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
SIGNATURE OF EVALUATOR
TITLE OF EVALUATOR
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