Atch_5_Question.docx

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Attached to
MT-1 Processing Services Federal contract opportunity
Solicitation number
HSFE60-14-R-0001
Issued by
Federal Emergency Management Agency Mitigation Section

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amd_003.pdf PDF
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HSFE60-14-R-0001_amd_1.pdf PDF
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HSFE60-14-F-0001ATTACHMENT 5
February 18, 2014

ORGANIZATION’S PERFORMANCE QUESTIONNAIRE

ORGANIZATION’S PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection

Please complete this questionnaire and mail or send by email to:

Dana Weimar
FEMADesired Response Date: March 19, 2014

395 E St. SW, 5th Floor Washington, DC 20472 Email: Dana.Weimar-Nuila@fema.dhs.gov

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

1) TO BE COMPLETED BY CONTRACTOR

1. CONTRACTOR’S NAME AND ADDRESS

4. CONTRACT NO.:

5. CONTRACT INITIATION DATE:

6. COMPLETION DATE:

7. CONTRACT VALUE $

2. PROJECT NAME:
8. TYPE OF CONTRACT:
9. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:

Please add a continuation page if additional space is necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

10. EVALUATION

a. EVALUATOR’S NAME, POSITION DURING PROJECT EXECUTION (Project Manager/COR/Other) AND ORGANIZATION

b. EVALUATOR’S PHONE NUMBER

c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please check the response code for each topic that best reflects your experience with this contractor:
EX = Exceptional VG = Very GoodS = SatisfactoryMG = Marginal US = Unsatisfactory N/O = Not Observed
A. Quality of Products and Services- Assess the contractor’s conformance to contract requirements.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
B. Overall Performance- Assess the contractor’s overall performance for the project.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
C. Schedule- Assess the timeliness of the contractor against the schedule of activities (as appropriate).
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
D. Technical Requirements- Assess the contractor’s ability and capacity to fulfill the technical requirements of the contract.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
E. Cost Control- Assess the contractor’s willingness and ability to manage the contract budget and control costs.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
F. Subcontracting- Assess the contractor’s success at complying with subcontracting goals.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
G. Customer Satisfaction- Assess the contractor’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
H. Customer Satisfaction- Assess the contractor’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O
I. Repeat Business- Assess the likelihood that you would want this contractor to perform another contract for you in the near future.
|_|EX|_|VG|_|S|_|MG|_|US|_|N/O

J. List contractor’s Weak Points:

K. List contractor’s Strong Points:

L. List any other projects this contractor has completed for you:

M. If an incentive contract, describe the type of incentive involved and the contractor’s success in earning its incentives.

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