Attachment_5_-_Past_Performance_Questionnaire.pdf

HSHQDC-17-Q-00457 – Attachment 5 Past Performance Questionnaire

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Completed questionnaires shall be received no later than 4:00PM Eastern on September 20, 2017.

Please submit questionnaires directly to:

Christiane.Schmidt@hq.dhs.gov and Jennifer.Daddio@hq.dhs.gov and please list the RFQ # “HSHQDC-17-Q-00457 Past Performance” in the subject line.

Points of Contact regarding this questionnaire:

Jennifer D’Addio Christiane Schmidt Contracting Officer Contract Specialist jennifer.daddio@hq.dhs.gov christiane.schmidt@hq.dhs.gov 202-254-8988 202-254-8863

Name of Prime Contractor submitting quote in response to RFQ # HSHQDC-17-Q-00457: _________________________________________

CONTRACT IDENTIFICATION (To be completed by Quoter)

Contractor/Company Name/Division:

Program/Project Title:

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

Contract Number/Task Order Number:

Contract Type:

Period of Performance:

General description of products/services required under the contract:

mailto:Christiane.Schmidt@hq.dhs.gov mailto:Jennifer.Daddio@hq.dhs.gov mailto:jennifer.daddio@hq.dhs.gov mailto:christiane.schmidt@hq.dhs.gov

RATINGS

The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some moderate problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

QUALITY OF PRODUCT OR SERVICE:

1. Compliance of products, services, documents, and related deliverables with contract requirements:

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

2. Accuracy and quality of reports and deliverables:

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below)

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

Good Acceptable Marginal (Explanation must be provided in Comments field below)

4. Capability of personnel to perform required services:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

5. Effectiveness of personnel in performing required services:

Acceptable Marginal (Explanation must be provided in Comments field below)

6. Overall quality of product/service:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

TIMELINESS OF PERFORMANCE:

1. Reliability:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

2. Responsive to technical direction:

Acceptable Marginal (Explanation must be provided in Comments field below)

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

Good Acceptable Marginal (Explanation must be provided in Comments field below)

BUSINESS RELATIONS:

1. Effectiveness of management, including managing their subcontractors:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

2. Reasonable/cooperative behavior:

Acceptable Marginal (Explanation must be provided in Comments field below)

3. Responsive to contract requirements:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

4. Notification of problems:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

5. Flexibility:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

6. Pro-active vs. reactive:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

COST CONTROL:

1. Current, accurate and complete billings:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

2. Relationship of negotiated costs to actuals:

Good Acceptable

3. Cost efficiencies:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

CUSTOMER SATISFACTION:

1. Commitment to Customer Satisfaction of Contractor Management Personnel:

Good Acceptable Marginal (Explanation must be provided in Comments field below)

2. Commitment to Customer Satisfaction of Contractor Onsite Facility Personnel:

Good Acceptable

ADDITIONAL COMMENTS: (Please provide any other relevant performance information.)

Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Role on the subject contract:

Telephone Number Address:

E-mail Address:

Signature of Respondent Date