HSHQDC-13-R-00047_-_Attachment_4_-_27_June_-_Tracked_Changes.pdf

HSHQDC-13-R-00047 Attachment 4

Past Performance Information Contractor Performance Customer Survey Questionnaire

Please complete the following questionnaire and return it to the attention of the individuals named below, no later than July 0108, 2013 at 4:00 PM ET.

Paula Nusbaum, Contracting Officer E-mail: Paula.Nusbaum@hq.dhs.gov Telephone: 202-447-0907

Elizabeth Walsh, Contract Specialist E-mail: Elizabeth.Walsh@hq.dhs.gov Telephone: 202-447-0197

Department/Component: Department of Homeland Security, Office of the Chief Security Officer

Solicitation Number: HSHQDC-13-R-00047

This survey pertains to a requirement for an end-to-end solution for the Department of Homeland Security (DHS)-wide implementation of Homeland Security Presidential Directive 12 (HSPD- 12), inclusive of an Integrated Data Management System (IDMS) and Enrollment Issuance Workstations (EIWS).

Please note that we will accept a Contractor Performance Assessment Reporting System (CPARS) evaluation form in lieu of this questionnaire, if applicable.

Date of Survey: ________________________________________________________________

Name of Company/Firm Being Reviewed: ___________________________________________________

Name of Person Completing Survey: _______________________________________________

Signature of Person Completing Survey: _____________________________________________

Your Company/Agency: _________________________________________________________

Your Role in this Contract: _______________________________________________________

Survey Period of Performance: ____________________________________________________

General description of products/services required under the contract/task order: __________

RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible.

Assign each area a rating of either 4 (Outstanding), 3 (Good), 2 (Acceptable), or 1 (Unsatisfactory). Use the attached Rating Guidelines as guidance in making these evaluations.

Circle the appropriate rating. Annotate with N/A if not a rating consideration or inapplicable to the contract effort.

QUALITY OF PRODUCT OR SERVICE:

1. Compliance with contract requirements:

1 2 3 4 N/A

2. Accuracy of reports:

1 2 3 4 N/A

3. Level of knowledge, experience, and training of personnel:

1 2 3 4 N/A

4. Capability of personnel to perform required services:

1 2 3 4 N/A

5. Effectiveness of personnel in performing required services:

1 2 3 4 N/A

6. Overall quality of product/service:

1 2 3 4 N/A

7. Product performance:

1 2 3 4 N/A

8. Spare parts availability:

1 2 3 4 N/A

9. Ease of use:

1 2 3 4 N/A

10. Quality and timeliness of warranty work:

TIMELINESS OF PERFORMANCE:

1. Reliability:

1 2 3 4 N/A

2. Responsive to technical direction:

1 2 3 4 N/A

3. Meets contract delivery schedules and/or task deadlines:

1 2 3 4 N/A

BUSINESS RELATIONS:

1. Effective management, including subcontracts:

1 2 3 4 N/A

2. Reasonable/cooperative behavior:

1 2 3 4 N/A

3. Responsive to contract requirements:

1 2 3 4 N/A

4. Notification of problems:

1 2 3 4 N/A

5. Flexibility:

1 2 3 4 N/A

6. Pro-active vs. reactive:

COST CONTROL:

1. Current, accurate and complete billings:

1 2 3 4 N/A

2. Relationship of negotiated costs to actuals:

1 2 3 4 N/A

3. Cost efficiencies:

CUSTOMER SATISFACTION:

1. The contractor is committed to customer satisfaction:

a. Contractor Management Personnel

(circle one) Yes No

b. Contractor Onsite Facility Personnel

(circle one) Yes No

ADDITIONAL COMMENTS: