Attachment_4_-_Past_Performance_Questionnaire.doc

Attachment 4

HSCG23-14-R-MPE209

PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE QUESTIONNAIRE

Contractor Name

Name of Rating Agency

Rater’s Phone:

Contract Type

Rater’s Email:

Contract Number

Place of Performance

Period of Performance

Contract Value

The requirement for which this Past Performance Questionnaire is being submitted is in support of a procurement of software licenses for incident management and incident action planning (IAP) software.

Performance Grades:

Exceptional – Contractor’s performance significantly exceeded most or all contract requirements. The contractual performance of the element or sub element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.

Very Good – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The Contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

Satisfactory – Performance meets contractual requirements. The contractual performance of the element or sub-element may contain some minor problems for which corrective actions taken by the Contractor appear to be or were satisfactory.

Marginal – Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the Contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective action(s) appear or were ineffective.

Please circle the appropriate performance grade in each of the areas below for the contractor’s past performance as based on comments provided by the customer. Please provide any additional comments as well.

1. Commitment to Customer Satisfaction: To what degree was the Contractor considered responsive to and cooperative with customer personnel?

Unsatisfactory Marginal Satisfactory Very Good Exceptional

2. Quality of Services: This area of the questionnaire deals with adherence to the contract requirements, to include appropriateness of personnel, technical excellence, and overall compliance with Contract Terms and Conditions.

Unsatisfactory Marginal Satisfactory Very Good

3. Timeliness of Performance: The Contractor’s ability to meet milestones and delivery schedule, to include responsiveness to technical direction, completion of efforts on time, planning, monitoring, wrap up and contract administration.

Marginal Satisfactory Very Good

4. Subcontracts: If applicable, the Contractor’s administration of subcontracts was:

Satisfactory Very Good Exceptional

5. Has the Contractor ever been given a cure notice, a show cause notice, suspension of progress payments, or other letters directing the correction of a performance problem?

Yes______________

No_____________

If Yes, please explain:

6. Based on this Contractor’s overall performance, would you award this Contractor another Government Contract?

Yes______________ No_____________ Not Sure_________________

If no or not sure, please explain:

7. Contractor’s overall performance rating:

Satisfactory Very Good

Thank you for your time. Please return this survey via email to: Marlecia.M.Newby@uscg.mil and James.F.Ferguson@uscg.mil.