HSFE40-16-R-0002_PAST_PERFORMANCE_QUESTIONNAIRE.docx

ATTACHMENT 3

Past Performance Questionnaire Technical and Administrative Support Services

PLEASE RETURN THIS PACKAGE TO THE FEMA CONTRACT SPECIALIST BY

06-06-2016 The Department of Homeland Security (DHS)/ Federal Emergency Management Agency (FEMA) recently released a solicitation for a Contractor to provide Technical and Administrative Support Services for the Assistance to Firefighter Grant (AFG) Program. Offerors were asked to provide information on contracts similar in size and complexity to the Technical and Administrative Support Services for the AFG Program 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 to FEMA Contract Specialist, Carmen Ragin, via email at Carmen.Ragin@fema.dhs.gov . 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 Contract Specialist, Carmen Ragin, via email at Carmen.Ragin@fema.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 Mailing Address (Agency, Bldg./Room, Street, City, State, Zip)

Please fill out this form in accordance with the instructions provided. 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 town.

5. CUSTOMER SATISFACTION:

The contractor exhibited a commitment to customer satisfaction and achieved customer satisfaction.

6. RESPONSIVENESS AND ATTENTIVENESS: 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.

For #8 and #9, please answer “Yes” or “No” as appropriate

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?