Attachment_4-_Past_Peformance_Questionnaire_(Revised_Sept_5 _2014).doc

HSCEDM-14-R-00010

Attachment 4

Past Performance Release Letter

HSCEDM-14-R-00010 (Transportation Services for Unaccompanied Children)

[TO BE SENT ON COMPANY'S LETTERHEAD]

[Insert Client’s Address]

SUBJECT: Past Performance Questionnaire for [Insert Contract Number] Dear [Name of Client]:

We are currently responding to the U.S. Immigration and Customs Enforcement (ICE) Solicitation Number HSCEDM-14-R-00010 for Transportation Services for Unaccompanied Children. The procuring agency is requiring Offerors to identify customers and solicit their response regarding our performance.

We have identified your organization as having knowledge of our relevant past performance of services under Contract Number [Insert Contract Number].

We are requesting that you take a few moments to complete the attached questionnaire and send it directly to the contracting office via email to NortheastTeamInbox@ice.dhs.gov.

As this information will be used in the source selection evaluation process, we request that you complete and submit the survey by [Offerors insert RFP closing date]

Additionally, the information contained in the completed Present/Past Performance Questionnaire is considered sensitive and cannot be released to us, the offeror. If you have any questions about the acquisition or the attached questionnaire, please direct them to NortheastTeamInbox@ice.dhs.gov.

Your timely response in this matter is greatly appreciated.

Sincerely, [Offeror's signature]

[Title]

PAST PERFORMANCE QUESTIONNAIRE

REF: HSCEDM-14-R-00010 Transportation Services for Unaccompanied Children

PART ONE: INSTRUCTIONS

The company who has provided you with this form is proposing on an Immigration and Customs Enforcement (ICE) Request for Proposal (RFP) for Detention Management Services to include Transportation Services for Unaccompanied Children. Past Performance is an important part of the evaluation criteria for this acquisition, so your input is equally important.

Please provide an honest assessment and return the questionnaire to the ICE POC via email at NortheastTeamInbox@ice.dhs.gov no later than 10:00am EST, Wednesday, September 10, 2014.

PART TWO: GENERAL INFORMATION

1. VENDOR’S NAME AND ADDRESS:

2. CUSTOMER AGENCY:

2a. EVALUATOR:

Name

Title:

Phone Number: _________________________________________________________

Email: _________________________________________________________________

3. CONTRACT NUMBER:

4. CONTRACT VALUE: $_________________________________________________

5. CONTRACT AWARD DATE: ___________________________________________

6. CONTRACT COMPLETION DATE: _______________________________________

7. CONTRACT TYPE (Circle All That Apply): FP

CPFF

CPAF OTHER

8. COMPLEXITY OF WORK (Circle One Response): DIFFICULT ROUTINE

9. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

PART THREE: VENDOR PERFORMANCE RATING

On the following pages, please summarize the vendor’s performance. Each section has a set of questions with five possible adjectival ratings. Determine the adjectival rating that most nearly represents your experience with this vendor and indicate your assessment by placing an “X” under the appropriate heading. These sections are:

A. QUALITY OF SERVICE

B. CONTRACT PERFORMANCE

C. TIMELINESS OF PERFORMANCE

Also, it is very important (and beneficial to our evaluation) if you submit examples and/or comments as to why they were rated as such in the sections herein.

Adjectival ratings are defined below and should be used as a reference in assessing performance:

COMMENTS:

PART THREE: VENDOR PERFORMANCE RATING

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

YES

If so, by 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

WHY?

ADDITIONAL 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