Past Perform Questionnaire Janitorial Services.DOC

Attachment B Past Performance Questionnaire

DHS/FEMA Region I

Federal Regional Facility/

Vehicle Storage Administration Building

PLEASE RETURN THIS PACKAGE TO THE CONTRACT SPECIALIST BY May 13, 2009 4:30 p.m.

The Department of Homeland Security (DHS), FEMA, recently released a Request for Quote for Janitorial Services. Offerors were asked to provide information on contracts similar in nature, size and complexity to the present requirement on which they had performed in the past. An Offeror has submitted your name as a reference for past performance. (See blocks 1 & 2 below).

We need your opinion on how well the contractor performed on this contract. Please fill out the attached questionnaire and return it in an envelope both taped and signed across the seal. Questionnaire should be returned to:

Diane E. McKenzie

Contracting Officer

DHS/FEMA/Region 1

99 High St., 6th Floor

Boston, MA 02110

DHS/FEMA may contact you to clarify or verify any information provided. Your input will be confidential. Please note your comments will be used to form the basis for evaluation of this Offeror. Thank you in advance for your assistance. If you have any questions, please contact, Diane E. McKenzie, Contracting Officer, at (617) 956-7529 or by email at diane.mckenzie@dhs.gov.

CERTIFICATION

By law, the Government will not disclose the names of individuals providing reference information during discussions with the contractor identified in Block 1 below.

Block 1. Contractor |

Block 2. Contract Name/Identifier |

I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS QUESTIONNAIRE IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Evaluator’s Printed Name Title/Role (e.g. Program Manager, Contracting Officer)

Evaluator’s Mailing Address (Agency, Bldg/Room, Street, City, State, Zip)

Evaluator’s Signature

Date

Phone

Fax

INSTRUCTIONS

Two forms are provided to document your opinion: 1) Performance Rating Form; and 2) Supplemental Comment Form. Please fill out each form in accordance with the instructions provided on each. Please use the following standards in arriving at your rating:

Outstanding - Contractor, on balance, exceeded client expectations and requirements

Satisfactory - Contractor, on balance, met customer expectations and requirements

Unsatisfactory - Contractor, on balance, was either marginal or did not meet customer expectations and requirements

Other - The element is not applicable, no data has been obtained, or additional comments are provided

1. QUALITY OF SOLUTION: The contractor comprehended the goals, thoroughly researched the problem, and presented a comprehensive, complete, feasible, and effective solution. (Met the needs and performed successfully).

2. EFFECTIVE AND EFFICIENT USE OF RESOURCES: The contractor deployed, in a timely manner, the proper amount and type of personnel, facilities and other resources to support the project. Use of subcontractors was appropriate in supporting the project.

3. COMMUNICATION: The contractor worked and communicated well with client management, staff, and contracting officials as well as with his or her own staff and subcontractors.

4. TIMELINESS OF PERFORMANCE: The contractor planned and proposed realistic schedules, successfully monitored performance and completed work on time.

5. CUSTOMER SATISFACTION: The contractor exhibited a commitment to customer satisfaction and achieved customer satisfaction.

7. COST CONTROL: The contractor successfully planned and proposed realistic costs and monitored performance, and consistently operated at or below budget.

8. Given the choice would you do business with this contractor again?

9. Did either you or the contractor have to resort to litigation to resolve problems?

Supplemental Comment Form

Please provide any additional comments regarding your performance element ratings in the appropriate spaces below. Please add additional pages as necessary.

Performance Element #1, Quality of Solution

Performance Element #2, Effective and Efficient Use of Resources

Performance Element #3, Communication

Performance Element #4, Timeliness of Performance

Performance Element #5, Customer Satisfaction

Performance Element #6, Responsiveness and Attentiveness

Performance Element #7, Cost Control

Question #8, Given the choice would you do business with this contractor again?

Question #9, Did either you or the contractor have to resort to litigation to resolve problems?

Additional Comments