PAST PERFORMANCE QUESTIONNAIRE.docx

DOCX document 21 KB Posted

Attached to
FEMA Temporary Housing Units Federal contract opportunity
Solicitation number
HSFEHQ-12-R-0002
Issued by
Federal Emergency Management Agency Logistics Section

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Sample Past Performance Questionnaire

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HSFEHQ-12-R-0002 A00004.pdf PDF
HSFEHQ-12-R-0002_Attach2_vAA_June 8 2012.pdf PDF
HSFEHQ-12-R-0002_Solicitation 20120608 .pdf PDF
HSFEHQ-12-R-0002_Attach2_vAA_2012-04-05 _May 15 2012.pdf PDF
HSFEHQ-12-R-0002_A00003.pdf PDF
HSFEHQ-12-R-0002_A00002.pdf PDF
HSFEHQ-12-R-0002_AdditionalGovernmentResponses.pdf PDF
HSFEHQ-12-R-0002_A0001.pdf PDF
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HSFEHQ-12-R-0002_Attach2.pdf PDF
HSFEHQ-12-R-0002_GovtResponses.pdf PDF
HSFEHQ-12-R-0002_Attach2.pdf PDF
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PAST PERFORMANCE QUESTIONNAIRE

One of the considerations in proposal evaluation is the verification of an offeror’s past and/or current performance on contracts, which may demonstrate the offeror’s ability to perform on the proposed effort. For an accurate evaluation, we rely on agencies and companies such as yours to share firsthand experience with a particular offeror. You and your agency/office were provided as a reference or determined to be a valid reference for _________________________________________.

Please provide your candid responses. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that your information be a factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire within 3 days. Thank you.

Your completed questionnaire will become a part of the official source selection records. We may release the information from the questionnaire to the contractor during negotiations or debriefings. If we release information from the questionnaire, the rater’s name will remain confidential.

Rating Guidelines

Use the following guidelines for (8) eight performance assessment areas. In all areas, an assignment of Neutral (N) is applicable if there is no identifiable performance record (see FAR 15.305(a) (2) (iii) and (iv)). You are asked to provide frank, concise comments regarding your overall assessment of the contractor’s performance on the contract identified. You are urged to supplement your own knowledge of the contractor’s performance with the judgment of others in your organization.

Excellent/Very Low Risk. Based on the offeror’s past performance, very little doubt exists that the offeror will successfully perform the required effort.

Good/Low Risk. Based on the offeror’s past performance, little doubt exists that the offeror will successfully perform the required effort.

Satisfactory/Moderate Risk. Based on the offeror’s past performance, some doubt exists that the offeror will successfully perform the required effort.

Unsatisfactory/High Risk. Based on the offeror’s past performance, significant doubt exists that the offeror will successfully perform the required effort.

Neutral/Unknown Risk. The offeror had little or no recent/relevant past performance upon which to base a meaningful performance risk prediction.

We request that the questionnaire package be completed and returned as soon as possible via electronic mail to Mr. Rahsaan A. Edwards, Contract Specialist, rahsaan.edwards@fema.dhs.gov. Facsimile transmissions will not be accepted. Transmission problems may be addressed to (202) 646-5786. Thank you for your time and assistance.

Regards, Past Performance Evaluation Team

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contact Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Award Amount:

B. IDENTIFICATION OF RESPONDENT

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

Evaluation

Please indicate your satisfaction with the contactor’s performance by placing an “X” in the appropriate block using the scale provided. This scale is defined as follows:

Code Performance level

E Exception / Very Low Risk

G Good / Low Risk

S Satisfactory / Moderate Risk

N Neutral / Unknown Risk

U Unsatisfactory / High Risk

1. Program Management

E
G
S
N
U

Effectiveness of overall contract management (including ability to effectively lead, mange, and control the program) and corporate oversight

Ability to successfully respond to urgent and/or high volume situations

Adherence to contract quality assurance requirements

Effectiveness of material management (including Government Furnished property of Equipment)

Timeliness/completeness/accuracy of submission of required reports and documentation

Timeliness/effectiveness of contract problem resolution

Ability to meet the schedule or complete services early compared to the schedule on an order/activity or project

Effectiveness of Environmental Compliance

2. Personnel Management

E
G
S
N
U

Adequately provided a trained and certified workforce during transition and contract start date

Maintained a workforce that possessed requisite technical knowledge, skills, and certifications (as required) throughout the life of the contract

Provided a stable work force with minimal personnel turnover that maintained project management continuity.

Proven ability to “staff up” to satisfy requirement

3. Schedule Performance

E
G
S
N
U

Timeliness of Performance for Services, including the Administrative Aspects of Performance

Timely completion of delivery orders, milestones

Effective processes ensuring responsiveness to potential or actual schedule slips

Responsive to technical changes

4. Problem Resolution

E
G
S
N
U

Prompt notification of problems

Effective root cause analysis, contractor-recommended solutions and corrective action plans

5. Transition

E
G
S
N
U

Contractor successfully transitioned resources and personnel to assume work under new contract; continuity of services was maintained and seamless

Effectiveness in transitioning to a new contract without compromising mission support

6. Cost Control (If Applicable)

E
G
S
N
U

Maintains accurate cost documentation

Minimizes cost overruns

Provides prompt notification to customer of potential cost overruns

Effectiveness in Forecasting and Controlling Project Cost

7. Customer Satisfaction

E
G
S
N
U

Commitment to Customer Satisfaction and Business-like Concern for its Customer’s Interest

Overall Satisfaction with Offeror

8. Safety

E
G
S
N
U

Commitment to Safe operations

Effectiveness of Safety Program

1) For Government contract references: Please provide an approximate number of documented complaints issued during performance of this contract.

2) Please provide an approximate dollar amount of contract payment deductions based on any performance problems.

3) For Commercial contract references: Please specify if you issued notices to the contractor due to the contractor’s failure to meet contract requirements, failure to perform the contract on schedule and/or poor workmanship. If any were issued, please provide an approximate number and description.

4) If there were any failure notices issued as described above, please note if the contract value was reduced based on those notices.

5) Approximately how much of this effort was subcontracted?

6) If this effort includes a high amount of subcontracting (greater than 50%), how many subcontracts were involved?

7) Were any problems encountered during start-up of the contract?

8) Would you award another contract to this contractor?

________________________________________
Evaluator’s SignatureDate

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