Past__Performance_Sample_Survey_Questionnaire.docx

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ADMINISTRATIVE/FRONT DESK SUPPORT SERVICES Federal contract opportunity
Solicitation number
HSIGAQ-15-R-00003
Issued by
Department of Homeland Security Office of the Inspector General

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Past Performance Questionnaire

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Attachment 5 - Past Performance Information Contractor Performance Customer Survey Questionnaire

Please complete the following questionnaire and return it to the attention of the individual named below, no later than June 3, 2016:

Willie Lindsey Name Contracting Officer Title Willie.Lindsey@OIG.DHS.GOV Address 202-734-3132 Telephone Number/Fax Number

This survey pertains to: _

Department/Component:

Solicitation Number:

Date of Survey:

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:

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:

1 2 3 4 N/A

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:

1 2 3 4 N/A

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:

1 2 3 4 N/A

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:

Rating Guidelines

QUALITY OF PRODUCT OR SERVICE
COST CONTROL
TIMELINESS OF PERFORMANCE
BUSINESS RELATIONS
4-Outstanding
There were no quality issues, and the contractor significantly exceeded the contract performance requirements without commensurate additional costs to the customer.
There were no cost management issues, and the contractor significantly exceeded the contract requirements, achieving cost savings to the customer.
There were no delays, and the contractor significantly bettered the agreed upon schedule.
Responses to inquiries, technical/service/administrative issues significantly exceeded customer expectations.
3-Good
There were no, or minimal, quality problems, and the contractor exceeded the contract requirements.
There were no, or minimal, cost management issues, and the contractor exceeded the contract requirements.
There were no, or minimal, delays that affected achievement of contract requirements; however, the contractor was still able to better or meet the agreed upon schedule.
Responses to inquiries, technical/service/administrative issues exceeded the contract requirements.
2-Acceptable
The contractor met the contract requirements. However, overall compliance required some assistance from the customer.
The contractor met the contract requirements. However, customer provided some assistance to the contractor to manage costs.
The contractor met the agreed upon schedule. However, customer provided some assistance to ensure the contractor met the agreed upon schedule.
Responses to inquiries, technical/service/administrative issues met the contract requirements.
1-Unsatisfactory
Non-conformances compromised the achievement of contract requirements.
Contractor was unable to manage costs effectively.
Contractor delays jeopardized achievement of contract objectives.
Responses to inquiries, technical/service/administrative issues were not timely or effective.

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