Attachment_2_Past_Performance_Questionaire__August_2016_v1.0.pdf

PAST PERFORMANCE QUESTIONNAIRE

The Department of Homeland Security (DHS), FEMA, recently released a Request for proposal: for Generator Maintenance at Distribution Caribbean 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 may submit you 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 send it electronically to either or.

Questionnaires must be received by ___________ (closing date/time of RFP) in order to be considered. 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 either electronically or telephonically at

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

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:

Neutral: Offeror has no relevant past performance.

Superior: Past performance significantly exceeded requirements.

Satisfactory: Past performance met requirements.

Unsatisfactory: Past performance significantly failed to meet requirements due to fault of contractor.

RFP:

FEMA DC Caribbean Generator Maintenance_Past Performance Questionnaire as of: 8/29/16

Performance Rating Form

Performance Element Neutral Superior Satisfactory Unsatisfactory

1. QUALITY OF SERVICES: The contractor provided high quality of service 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.

6. RESPONSIVENESS AND

ATTENTIVESNESS: The contractor exhibited reasonable and cooperative behavior in response to client changes, criticism/rejection of contract deliverables and in detecting and correcting errors, poor performance, and other problems.

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

8. SUBCONTRACTING PLAN: The contractor put forth good faith effort in meeting it small and disadvantaged business goals.

YES NO

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

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 Services:

Performance Element #2, Effective and Efficient Use of Resources:

Performance Element #3, Communication:

Performance Element #4, Timeliness of Performance:

Supplemental Comment Form cont’d

Performance Element #5, Customer Satisfaction:

Performance Element #6, Responsiveness and Attentiveness:

Performance Element #7, Cost Control:

Performance Element #8, Subcontracting Plan:

Question #8:

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

Additional Comments: