Attachment L-2 Past Performance Questionnaire.docx
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- HSHQDC-12-R-00033
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Attachment L-2 Past Performance Questionnaire
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PAST PERFORMANCE EVALUATION QUESTIONNAIRE
INSTRUCTIONS TO OFFERORS SENDING REFERENCE QUESTIONNAIRE FORMS:
Section A (Part I and Part II) shall be completed by the Offeror (the firm requesting the reference) prior to issuing the questionnaires. The Offeror shall send the questionnaires for relevant projects that are in progress or completed in the past three (3) years to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for Government contracts. It is the responsibility of the Offeror to follow-up and encourage references to submit the questionnaire. The completed questionnaire shall be submitted via e-mail directly from the person providing the reference.
INSTRUCTIONS TO PERSON PROVIDING REFERENCE:
In order to assess potential vendors under the Department of Homeland Security (DHS) Research and Development Test and Evaluation (RDT&E) Systems Engineering and Technical Assistance (SETA), Indefinite-Delivery, Indefinite-Quantity (IDIQ) contract, the DHS contracting office is obtaining past performance information with respect to each Offeror. As a reference for work performed by the firm identified in Section A of this questionnaire, your candid response will assist in the evaluation process. Please complete Section B (Part I and Part II) of the questionnaire as thoroughly as possible and submit to S&TIDIQ@HQ.DHS.GOV no later than ____________. The subject line in the submission e-mail shall clearly indicate: S&T RDT&E SETA Past Performance Questionnaire Submission for <Company Name> and the message shall originate from the reference’s government or commercial e-mail system.
In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is a major DHS acquisition and your input into this evaluation is greatly appreciated. If you have questions regarding this questionnaire or require assistance, please submit inquiries to S&TIDIQ@HQ.DHS.GOV.
Sincerely, Carolyn Smith, Contracting Officer
SECTION A
TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)
PART I: SETA OFFEROR INFORMATION
COMPANY NAME AND DIVISION NAME OF OFFEROR:
OFFEROR ADDRESS:
OFFEROR DUNS:
PART II: PAST PERFORMANCE INFORMATION
TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:
PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):
TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID):
PRICING TYPE: (Check all that apply) |_| FP |_| FP-EAP |_| CPFF-Completion |_| CPFF-Term |_| CPIF |_| CPAF |_| ID/IA |_| BOA
|_| Requirements |_| Labor-Hour |_| T&M |_| CR |_| Other (Specify) _______________
DATE OF AWARD:
PERIOD OF PERFORMANCE (INCLUDING OPTIONS):
CONTRACT AMOUNT:
· INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________
· FINAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________
ROLE ON PROJECT:
|_| PRIME
|_| SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF APPLICABLE):
|_| OTHER (EXPLAIN)
GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:
DESCRIBE COMPLEXITY OF WORK:
SECTION B
TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)
PART I: REFERENCE INFORMATION
NAME & TITLE:
ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):
CONTRACT ROLE (e.g. CO, COTR, PM):
ADDRESS:
PHONE NUMBER:
FAX NUMBER:
E-MAIL:
PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED
Please identify and correct any information that is not accurate in Section A.
Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:
· Superior (Based on an offeror’s past performance record, essentially no doubt exists that the offeror will successfully perform the required effort.)
· Satisfactory (Based on an offeror’s past performance record, some doubt exists that the offeror will successfully perform the required effort.)
· Unsatisfactory (Based on an offeror’s past performance record, extreme doubt exists that the offeror will successfully perform the required effort.)
· Neutral (No relevant performance record is identifiable upon which to base a meaningful performance rating. This is neither a negative or positive assessment.)
Performance Element
Superior
Satisfactory
Unsatisfactory
Neutral
QUALITY OF PRODUCT OR SERVICE
1. The Contractor provided a product or service that conformed to contract requirements, specifications, and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).
2. The Contractor submitted accurate reports.
3. The Contractor utilized personnel that were appropriate to the effort performed.
COST CONTROL
1. The Contractor performed the effort within the estimated cost/price.
Satisfactory
Unsatisfactory
2. The Contractor submitted accurate invoices on a timely basis.
3. The Contractor demonstrated cost efficiencies in performing the required effort.
4. The actual costs/rates realized closely reflected the negotiated costs/rates.
SCHEDULE
1. The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract.
2. The Contractor was responsive to technical and/or contractual direction.
BUSINESS RELATIONSHIPS
1. The Contractor demonstrated effective management over the effort performed.
2. The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) and/or Technical Point of Contact (TPOC) were apprised of technical, cost, and schedule issues.
3. The Contractor presented information and correspondence in a clear, concise, and businesslike manner.
4. The Contractor promptly notified the COR, TPOC, and/or Contracting Officer in a timely manner regarding urgent issues.
5. The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical program issues.
6. The Contractor made timely award to, and demonstrated effective management of, its subcontractors.
CUSTOMER SATISFACTION
1. The products/services provided adequately met the needs of the program.
2. The Contractor was able to perform with minimal or no direction from the COR or the TPOC.
MANAGEMENT OF KEY PERSONNEL
Satisfactory
Unsatisfactory
1. The contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.
UTILIZATION OF SMALL BUSINESS
1. FAR Subpart 19.7 and 15 U.S.C. 637 contains statutory requirements for complying with the Small Business subcontracting Program. Assess whether the contractor provided maximum practicable opportunity for small business to participate in contract performance consistent with efficient performance of the contract.
PLEASE ANSWER “Yes” or “No”, as appropriate
Given the choice, would you do business with this contractor again?
| YES |
| NO |
Additional comments you would like to share
| _____________________________ | ____________________ | |
| SIGNATURE | DATE: |
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