HSCEDM-17-R-00002_Attachment_10_-_Past_Performance_Questionaire.pdf

HSCEDM-17-R-00002 Attachment 10 – Past Performance Questionnaire

CONTRACT PERFORMANCE SURVEY Page 1 of 2

* Please provide a brief description of services rendered by the contractor in the block highlighted in yellow, below.

Name of Contractor Being Reviewed

Contract Number/Reference Information/Contracting Officer/POC N/A Name of Agency/Customer Organization Submitting Review for this Contractor

Name of Person Completing Questionnaire / Being Interviewed Phone Number Email Address

Period of Performance:

C/S fills this in

Total Contract Value:

C/S fills this in

Brief Description of Services:

Contract Performance Information

In accordance with Federal Acquisition Regulation (FAR), Subparts 9.104-1 and 9.104-2 prospective offerors seeking federal government contracts must disclose and submit Past Performance information.

You are listed as a reference by the subject contractor; please fill out this questionnaire and provide at least a brief explain why you feel that the contractor has or has not performed well.

Respond to: Contract Specialist, rose.arenas@ice.dhs.gov AND pamela.a.rodgers@ice.dhs.gov Please call me if you have questions regarding this survey or wish to discuss this contractor’s performance personally.

Questions: Response:

1. How would you rate your confidence in the contractor’s compliance with contract terms and conditions?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence � No Confidence

Comment:

2. How would you rate your confidence in the contractor’s ability to respond promptly to your needs?

� Substantial Confidence � Satisfactory Confidence � Limited Confidence � Unknown/Neutral Confidence

3. How would you rate your confidence in the contractor’s ability to complete work on schedule?

� Limited Confidence � Unknown/Neutral Confidence � No Confidence

Comment:

mailto:rose.arenas@ice.dhs.gov mailto:pamela.a.rodgers@ice.dhs.gov

HSCEDM-17-R-00002 Attachment 10 – Past Performance Questionnaire

4. How would you rate your confidence in the contractor’s ability to comply with contract requirements?

� Limited Confidence � Unknown/Neutral Confidence

5. How would you rate your confidence in the contractor’s ability to take appropriate corrective measures to prevent problems and/or problem reoccurrence?

� Limited Confidence � Unknown/Neutral Confidence

6. Would you recommend and/or do business with this contractor in the future? If your answer is No, please explain why.

� Yes � No

7. Were there any issues not discussed above or do you have any additional comments on the contractor’s performance that you would like to discuss?

� Yes � No

Additional Comments:

The Immigration and Customs Enforcement, (ICE), sincerely thanks you for taking the time to complete this questionnaire and for your contribution to the success of our acquisition program.