Attachment D PAST PERFORMANCE

ATTACHMENT D

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company who has provided you with this form is responding to an Immigration and Customs Enforcement (ICE) RFQ No. HSCEMS-09-R-00025 for four (4) deployable tactical Radio Interoperability Systems and one (1) fixed facility system interface that allows for the connectivity between the four deployable systems and the current RIOS and satellite systems in the FPS Mobile Command Vehicles. 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 Contract Specialist, Jeremy Pierre at the address listed below. This information will not be disclosed to the offeror. Please provide an honest assessment and return the questionnaire to ICE by email or fax (email preferred) to the address shown below, no later than Friday, September 4, 2009 at 12:00 Noon Eastern Daylight Time.

Immigration and Customs Enforcement

Attn: Jeremy Pierre, Contract Specialist 801 I Street, NW, Room 980-38 Washington, DC 20536

Jeremy.pierre@dhs.gov Fax: (202)732-7201 Phone: (202) 732-2649

PART TWO: GENERAL INFORMATION

1. OFFEROR’S NAME AND ADDRESS

2. CUSTOMER ORGANIZATION

3. CONTRACT NUMBER:

2a. EVALUATOR

4. CONTRACT VALUE (Circle One):

NAME:

<$25K $25K - $100K >$500K

TITLE:

PHONE NO:

5. CONTRACT AWARD DATE:

6. CONTRACT COMPLETION DATE:

7. CONTRACT TYPE (Circle All That Apply):

8. COMPLEXITY OF WORK (Circle

One Response):

FP

CPFF

CPAF

OTHER

DIFFICULT

ROUTINE

PART TWO: GENERAL INFORMATION CONTINUED

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 five possible adjectival ratings. Determine the adjectival 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 SERVICE

B. CONTRACT PERFORMANCE

C. TIMELINESS OF PERFORMANCE

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

In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available, the offeror may not be evaluated favorably or unfavorably on past performance.

PART THREE: OFFEROR PERFORMANCE RATING

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

DATE

ATTACHMENT C-1

*To be completed by the Offeror NOT Evaluator

INSTRUCTIONS: Offerors responding to the RFQ HSCEMS-09-R-00025 must provide the following information with the applicable proposal submittals. This form is not applicable to the said Evaluator(s).

List of each of the agencies/companies that will be receiving the “PAST PERFORMANCE QUESTIONNAIRE”.

1.

2.

3.

4.

5.

ATTACHMENT F

PAGE

RFQ: HSCEMS-09-R-00025

Deployable and Fixed Facility Tactical Radio Interoperability Systems