Attachment_5_Past_Performance_Survey.pdf

HSFE70-16-R-0011 --- Attachment 5

PAST PERFORMANCE SURVEY

One (1) copy of this survey shall be submitted via email, no later than January 30, 2017.

CONTACT NAME/ATTENTION TO:

Kimberly Coakley

E-MAIL ADDRESS

Kimberly.Coakley@fema.dhs.gov

REFERENCE:

HSFE70-16-R-0011

The Federal Emergency Management Agency (FEMA) is conducting an acquisition for the purchase of Air Transportation Support Services. You have been listed by [insert Contractor being evaluated] as a past performance customer reference who can assist us in determining the past performance history of this company. I request your assistance in responding to the following questions concerning their work performance. When responding to the questions, select the letter that most accurately describes the Contractor's performance. If the Contractor has no record of past performance relevant to a particular question, select “Neutral”.

E G M P N Excellent Good Marginal Poor Neutral

Performance in this area met all contract requirements and exceeded many to the customer’s benefit.

Problems, if any, were negligible and were resolved in a timely, highly effective manner.

this area met all contract requirements and exceeded some to the customer’s benefit. There were a few minor problems, which the Contractor resolved.

this area did not meet some contractual requirements.

There were problems, for which the Contractor’s corrective action was only marginally effective.

this area did not meet contractual requirements.

There were serious problems, and the Contractor’s’ corrective actions were ineffective.

No record of past performance or the record is inconclusive.

**Please Use the Comments Section on the last page to elaborate on any answer.**

Quality of Service

1. How would you rate the Contractor’s capability to provide the client with a quality service?

E ____ G ____ M ____ P ____ N ____

2. How would you rate the Contractor’s management of multiple delivery orders/requirements and subcontractors simultaneously?

E ____ G ____ M ____ P ____ N ____

3. How would you rate the Contractor’s capability to maintain current/up-to-date services on the contract?

E ____ G ____ M ____ P ____ N ____

4. How would you rate the Contractor’s technical and management performance (also, in the comments section include any recognition, awards, and/or acknowledgements if applicable)?

Cost Control

5. How would you rate the Contractor’s efforts to maintain competitive prices on the contract?

E ____ G ____ M ____ P ____ N ____

6. How would you rate the Contractor’s submission of reasonably priced change proposals?

E ____ G ____ M ____ P ____ N ____

7. How would you rate the Contractor’s Financial, Administrative and Billing Capacity?

Timeliness of Performance

8. How would you rate the Contractor’s ability to adhere to contract schedules, including response times and reliability?

Business Relations

9. How would you rate the Contractor’s responsiveness to inquiries, problem resolution, and ensuring customer satisfaction?

Overall Assessment

13. How would you rate the overall past performance of the services provided by this Contractor?

14. Would you use the contractor again? Yes_______ No_______

Explain No Answer

Please provide any other information and comments relating to this organization’s performance in the space provided below.

COMMENTS:

Contract Name: ______________________________________________________________

Contract Value: ______________________________________________________________

Contract Period of Performance: _________________________________________________

Name of Person Responding: ___________________________________________________

Title of Person Responding: ____________________________________________________

Telephone Number: __________________________________________________________

E-mail Address: _____________________________________________________________