Attachment A - Past Performance Questionnaire.doc

HSCENV-08-Q-00014

HSCEMD-09-Q-00007

ATTACHMEMENT A

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company who has provided you with this form is responding to a Department of Homeland Security, Immigration and Customs Enforcement (ICE) solicitation to provide Advanced Technical Legal Writing services. 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, the ICE Contracting Officer. This information will not be disclosed to the offeror. Please provide an honest assessment and return the questionnaire to ICE, by fax or mail, to the address shown below, no later than March 25, 2009. If you have questions, please contact Wes Ransom at (214) 905-5797 or wesley.ransom@dhs.gov. Facsimile copies are allowed. (214) 905-5568.

Office of Acquisition Management -Dallas

Attn: Wesley Ransom

7701 N. Stemmons Freeway, Suite 300

Dallas, TX 75247

PART TWO: GENERAL INFORMATION

PAST PERFORMANCE/EXPERIENCE QUESTIONNAIRE

PERFORMANCE EVALUATION

I. CONTRACT INDENTIFICATION

A.

CONTRACT NUMBER: _________________________________________________________

B.

OFFEROR: _______________________________________________________________

C.

TYPE OF CONTRACT:

_____ NEGOTIATED

_____ SEALED BID

_____ FIXED PRICE

_____ COST REIMBURSEMENT

_____ OTHER (SPECIFY)

D. COMPLEXITY OF WORK: _____ DIFFICULT _____ ROUTINE

E. CONTRACT AMOUNT: _____________________________________________________

F. CONTRACT PERIOD: _______________________________________________________

G: AGENCY NAME: ___________________________________________________________

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

III.

EVALUATION

A.

PERFORMANCE HISTORY

1.

To what extent did the offeror adhere to the contract delivery schedule?

· O ______ G ______ A ______ U ______

2.

To what extent did the offeror submit required reports and documentation in a timely manner?

· O ______ G ______ A ______ U ______

3.

To what extent were the offeror’s reports and documentation accurate and complete?

· O ______ G ______ A ______ U ______

4.

To what extent was the offeror able to solve contract performance problems without extensive guidance from government counterparts?

· O ______ G ______ A ______ U ______

5.

To what extent did the offeror display initiative in meeting requirements?

· O ______ G ______ A ______ U ______

6.

Did the offeror commit adequate resources in a timely fashion to the contract to meet the requirement and to successfully solve problems?

· O ______ G ______ A ______ U ______

7.

To what extent did the offeror respond positively and promptly to technical directions, contract change orders, etc.?

· O ______ G ______ A ______ U ______

8.

To what extent was the offeror’s maintenance and problem tracking/reporting documentation timely, accurate, and of appropriate content?

· O ______ G ______ A ______ U ______

B.

TERMINATION HISTORY

9.

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

_____ Yes

_____Default

_____ Convenience _____ No 10.

Are there any pending terminations?

_____ Yes _____ No

C. EXPERIENCE HISTORY

11.

How effective has the offeror been in identifying user requirements?

· O ______ G ______ A ______ U ______

D.

COST MANAGEMENT

12.

To what extent did the offeror meet the proposed cost estimate?

· O ______ G ______ A ______ U ______

Additional comments:

Printed Name of Reviewer: _______________________________________________________________

Title of Reviewer: ______________________________________________________________________

Phone Number: _______________________________________________________________

Signature: _______________________________________________ Date: ___________________

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