Attachment_3_-_Past_Performance_Questionnaire-Final.pdf

Attachment 3 – Past Performance Questionnaire

HSHQDN-17-R-0003

(Offeror to complete Part I prior to providing this questionnaire to the Evaluator.)

In order to assess potential vendors under the Department of Homeland Security (DHS)

Personal Radiation Detector (PRD) procurement (RFP No. HSHQDN-17-R-0003), the DHS contracting office is obtaining past performance information with respect to each offeror. The contract resulting from this procurement will provide DHS with commercial off the shelf

(COTS) PRD systems. In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is a critical acquisition being conducted by DHS and your support is sincerely appreciated. We are thanking you in advance for your time, effort, and cooperation in responding to this questionnaire. The completed Past Performance Questionnaire shall be submitted directly via email from the customer reference by the due date established for receipt of questionnaires. The message must originate from the customer reference email system. The “subject” line in the submission email shall clearly indicate: PRD Past

Performance Questionnaire Submission for Offeror <insert name>.

Please send an email with the Past Questionnaire as an attachment to:

PRDproposals@hq.dhs.gov

DO NOT RETURN THIS QUESTIONNAIRE TO THE OFFEROR

If you need more space than that provided, attach additional pages. Responses will be treated as source selection sensitive information. If you have any questions, please contact Danielle H.

Richardson and Heather Poindexter at the e-mail address indicated above.

mailto:PRDproposals@hq.dhs.gov

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 1

<INSERT OFFEROR NAME>

PART I – TO BE COMPLETED BY OFFEROR

A. CONTRACT INFORMATION:

1 Agency Name/Location:

2 Program/Project Title:

3 Type of Instrument (e.g.

Contract/Order/Subcontract/Other):

4 Contract Identification Number:

5 Order Number (If applicable):

6 Project Service Description (Add rows if needed):

7 Type of Contract (e.g.

Negotiated, Sealed Bid):

8 Pricing Type (e.g. fixed price, cost reimbursement, other):

9 Competitive (Y/N):

10 Follow-on Work Available

(Y/N):

Follow-on Work Awarded to

Offeror (Y/N):

11 Date of Award:

12 Initial Contract Dollar Value

(w/Options):

13 Final Contract Dollar Value

(w/Options):

14 Period of Performance:

15 Place(s) of Performance:

15 Complexity of Work (e.g.

difficult, routine, simple):

16 Type and extent of subcontracting (add rows if needed):

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 2

PART II – TO BE COMPLETED BY OFFEROR’S CLIENT

A. REFERENCE RESPONDENT INFORMATION

1 Name (please print):

2 Agency / Company:

3 Position Title:

4 Phone Number (include area code):

5 Fax Number (include area code):

6 Email Address:

7 Mailing Address:

8 Your Role Relative to the

Project/ Contract (e.g., COTR, PM):

9 Length of Involvement in

Project/Contract:

10 Questionnaire Completion Date:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 3

Questionnaire 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 ratings should be noted under Additional Comments. Assign each area a rating of 4

(Outstanding), 3 (Good), 2 (Acceptable), 1 (Unacceptable), and N/A (Not Applicable). Use the provided rating guidelines as guidance in making these evaluations. Circle the appropriate rating.

QUALITY OF

PRODUCT OR

SERVICE

COST CONTROL TIMELINESS OF

PERFORMANCE

BUSINESS RELATIONS

4- Outstanding Contractor is in compliance with contract requirements and/or delivers quality products/services.

Contractor is effective in managing costs and submits current, accurate, and complete billings.

Contractor is effective in meeting milestones and delivery schedules.

Response to inquiries, technical/service/administrative issues is effective.

3- Good Minor inefficiencies/errors have been identified.

Contractor is usually effective in managing costs.

Contractor is usually effective in meeting milestones and delivery schedules.

Response to inquiries, technical/service/administrative issues is usually effective.

2- Acceptable Some problems have been encountered.

Contractor is having some problems in managing costs effectively.

Contractor is having some problems meeting milestones and delivery schedules, but there is no jeopardy to contract performance.

Response to inquiries, technical/service/administrative issues is somewhat effective.

1- Unacceptable Contractor is not in compliance and is jeopardizing achievement of contract objectives.

Contractor is unable to manage costs effectively.

Contractor delays are jeopardizing performance of contract objectives.

Response to inquiries, technical/service/administrative issues is not effective.

N/A-Neutral No past performance available for evaluation. Offeror has no directly related or similarly relevant past performance experience. Proposals receive no merit or demit for this factor.

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 4

QUALITY OF PRODUCT:

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:

1 2 3 4 N/A

7. Product Performance:

1 2 3 4 N/A

8. Spare part availability:

1 2 3 4 N/A

9. Ease of use:

1 2 3 4 N/A

10. Quality and timeliness of warranty work:

ADDITIONAL COMMENTS:

TIMELINESS OF PERFORMANCE:

1. Reliability:

2. Responsive to technical direction:

1 2 3 4 N/A

3. Meets contract delivery schedule:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 5

BUSINESS RELATIONS:

1. Effective management, including subcontracts:

2. Reasonable/cooperative behavior:

1 2 3 4 N/A

3. Responsive to contract requirements:

1 2 3 4 N/A

4. Keeps Government abreast of potential problems:

1 2 3 4 N/A

5. Flexibility:

1 2 3 4 N/A

6. Pro-active versus reactive:

COST CONTROL

1. Current, accurate, and complete billings:

2. Relationship of negotiated costs to actuals:

1 2 3 4 N/A

3. Cost efficiencies:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 6

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