Attachment_2_-_Past_Performance_Questonnaire.doc

HSHQDC-15-R-00148

Attachment 2 - Past Performance Questionnaire

PAST PERFROMANCE INFORMATION

CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

Department of Homeland Security Office of Health Affairs

National Biosurveillance Integration Center

“Biosurveillance Real-Time Data Feed”

Please complete the following questionnaire and return to the attention of:

Carla Davis

Contracting Officer

Email: carla.davis@hq.dhs.gov

Charnelle Brown

Contract Specialist Email: charnelle.brown@hq.dhs.gov By 10:00 AM Eastern Standard Time (EST) August 21, 2015 This survey pertains to:

Contractor Information:

Contractor Name:

Contract Number (#):

Contract Type:

Contract Period of Performance this Survey Covers:

Contract Total (including all Option Periods):

General description of products/services required under the contract:

Survey Filler Information:

Name of Person Completing Survey:

Your Role in this Contract:

Your Company/Agency:

Address:

Telephone:

Date of Survey Completion:

Signature of Survey Filler:

RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Commentary to support very high or very low rating should be noted on page 6.

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

QUALITY OF SERVICE

1.

Compliance with contract requirements:

N/A

2.

Accuracy of reports

N/A

3.

Level of knowledge, experience, and training of personnel

N/A

4.

Capability of personnel to perform required services

N/A

5.

Effectiveness of personnel in performing required services

N/A

6.

Overall quality of service

N/A

TIMELINESS OF PERFORMANCE

1. Reliability

N/A

2. Responsive to technical direction

3. Meets contract delivery schedules and/or task deadlines

N/A

BUSINESS RELATIONS

1. Effective management, including subcontracts

2. Reasonable/cooperative behavior

3. Responsive to contract requirements

4. Notification of problems

5. Flexibility

6. Pro-active vs reactive

N/A

COST CONTROL

1.

Current, accurate and complete billings

N/A

2.

Relationship of negotiated costs to actuals

3. Cost efficiencies

N/A

CUSTOMER SATISFACTION

1.

The contractor is committed to customer satisfaction.

a. Contractor Management Personnel

Yes No (circle one)

b. Contractor Onsite Facility Personnel

Yes No (circle one)

ADDITIONAL COMMENTS:

Rating Guidelines