HSBP1017R0025_-_Attachment_3_(Past_Performance_Questionaire).doc

HSBP1017R0025 – Attachment 3

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company (i.e., the Offeror) who has provided you with this form is responding to a U.S. Customs and Border Protection (CBP) solicitation to provide Ballistic Plates for law enforcement officers. Past Performance is an extremely important part of the evaluation criteria for this acquisition, so your input is very important. The information is to be provided directly to Matt Korn, the CBP Contract Specialist. Please provide a candid assessment and return the questionnaire to CBP by email (preferred), fax or mail, to the address shown below, so that it is received no later than 3:00 PM EDT on July 11, 2017.

U.S. Customs and Border Protection

Attn: Matt Korn, Contract Specialist

Matthew.a.korn@cbp.dhs.gov

6650 Telecom Drive

Indianapolis, IN

(317) 614-4546 Fax: (317) 298-1344

PART TWO: GENERAL INFORMATION

1.

OFFEROR’S NAME AND ADDRESS

2.

CUSTOMER ORGANIZATION

3.

CONTRACT NUMBER:

4.

EVALUATOR

5.

CONTRACT VALUE (INCLUSIVE

NAME:

OF OPTION PERIODS):

TITLE:

PHONE:

6.

CONTRACT AWARD DATE:

7.

CONTRACT COMPLETION DATE

8.

CONTRACT TYPE (Circle All That Apply):

9.

COMPLEXITY OF WORK

(Circle One Response):

FFP

CPFF

CPAF

OTHER

DIFFICULT

ROUTINE

10.

BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS (BALLISTIC PLATE TYPE/LEVEL):

PART THREE: OFFEROR PERFORMANCE RATING

On the following pages, please summarize the offeror’s performance in each rating factor. Each factor has a set of subfactors with five possible point ratings. Determine the point score rating that most nearly represents your experience with this offeror and indicate your assessment by placing an “X” under the appropriate heading. Offeror performance factors are:

A.

QUALITY OF BALLISTIC PLATES

B. RESPONSIVENESS TO CUSTOMER REQUIREMENTS (TIMELINESS OF PERFORMANCE)

Adjective Ratings are defined below and should be used as a reference in assessing performance:

Exceptional Offeror’s performance significantly exceeded most or all contract requirements. Furthermore, the offeror provided significant, unusual, unique, or worthwhile features or benefits and performance was of the highest quality. No risk anticipated with performance or customer satisfaction.

Very Good Offeror’s performance fully exceeded many of the contract requirements.

Offeror’s performance has resulted in a high level of efficiency and productivity and quality. Very little risk anticipated with performance or lack of customer satisfaction.

Satisfactory Offeror’s performance met contract requirements. Some potential risk and lack of customer satisfaction could be anticipated based upon the offeror’s past performance.

Marginal Offeror’s performance was less than satisfactory and should have been better. Significant potential risk and degradation of performance could be anticipated based upon the offeror’s past performance.

No Rating Insufficient information is available for a rating in this area.

Rate the overall quality of the ballistic plates received.

Did the Offeror meet/exceed the delivery requirements established in the contract?

Was the Offeror proactive in notification of delivery problems?

1.

Has this contract been partially or completely terminated for default or convenience?

(Circle the appropriate answer.)

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 Offeror’s greatest strength in the performance of the contract?

3.

What was the Offeror’s greatest weakness in the performance of the contract?

4.

Would you award another contract to the Offeror?

YES

NO

5.

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

DATE