Attachment B - ASC QUESTIONNAIRE.doc

ATTACHMENT B HSSCCG-11-R-00010

Amendment 00001

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company who has provided you with this form is proposing on a Department of Homeland Security (DHS) solicitation to provide the Application Support Center (ASC) Operations and Facilities Services in support of the United States Citizenship and Immigration Services (USCIS) mission. Past Performance is an extremely important part of the evaluation criteria for this acquisition, so your input is very valuable. The completed questionnaire shall be submitted with the Offeror’s proposal in an annotated sealed envelope or emailed to Kristie Nestle, Contracting Officer at Kristie.Nestle@dhs.gov and Lindsey Mongeon, Contract Specialist at Lindsey.Mongeon@dhs.gov.

The completed questionnaire is due no later than 2:00pm EST on 6/24/2011. If you have questions, please contact Kristie Nestle, Contracting Officer at Kristie.Nestle@dhs.gov or (802)-872-4197 x4433.

PART TWO: GENERAL INFORMATION

1. OFFEROR’S NAME AND ADDRESS:

2. CUSTOMER ORGANIZATION AND EVALUATOR:

(name, address and phone number)

3. CONTRACT NUMBER:

4. CONTRACT VALUE:

5. CONTRACT AWARD DATE:

6. CONTRACT COMPLETION DATE:

7. CONTRACT TYPE:

8. COMPLEXITY OF WORK

(Circle All That Apply)

(Circle One Response):

FP

CPFF

CPAF

OTHER

DIFFICULT

ROUTINE

9. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

PART THREE: OFFEROR PERFORMANCE RATING

On the following pages, please summarize the Offeror’s performance in each subject area listed below. Determine the adjectival rating that most represents your experience with this Offeror and indicate your assessment by placing an “X” under the appropriate heading. Offeror performance subject areas are:

A. Quality of Product or Service: Conformance to contract requirements, specifications and standards of good workmanship, accuracy of reports, appropriateness of personnel, and technical excellence.

B. Cost Control: Within budget, current accurate and complete billings, actual cost/rates reflect closely to negotiated cost/rates, cost efficiency measures, adequate budgetary internal controls.

C. Schedule: Timeliness of performance, met interim milestones, reliable, responsive to technical and contractual direction, completed on time, including wrap-up and contract administration, no liquidated damages assessed.

D. Business Relationships: Effective management, businesslike correspondence, responsive to contract requirements, prompt notification of problems, reasonable/cooperative behavior, flexible, proactive, effective Contractor recommended solutions, timely award and management of subcontracts, effective small/small disadvantaged business subcontracting program.

E. Customer Satisfaction: Satisfaction of end users with the Contractor's service.

F. Key Personnel: How long key personnel stayed on the contract, how well they managed their portion of the contract, the quality and relevancy of the products/services generated by key personnel.

Adjectival ratings are defined below and should be used as a reference in assessing performance:

OUTSTANDING =

Offeror’s performance significantly exceeded most or all contract requirements. Furthermore, the offer provided significant, unusual, unique, or worthwhile features or benefits and performance was of the highest quality. No risk anticipated with performance or customer satisfaction.

GOOD

Offeror’s performance fully exceeded many of the contract requirements. Offeror’s performance has resulted in a high level of efficiency and productivity and quality. Very little risk anticipated with performance or lack of customer satisfaction.

ACCEPTABLE =

Offeror’s performance met customer expectations or contract requirements. Some potential risk and lack of customer satisfaction anticipated based upon the Offeror’s past performance.

UNACCEPTABLE=

Offeror’s performance was less than satisfactory and could have stood improvement. Significant potential risk and degradation of performance anticipated based upon the Offeror’s past performance.

N/A =

Not applicable to the contract rated.

NOTE: For statements indicating "Outstanding" or "Unacceptable", please provide a brief explanation.

PART THREE: OFFEROR PERFORMANCE RATING CONTINUED

1. Has this contract been partially or completely terminated for default or convenience? (Circle One

Response)

Yes No Default

Convenience

If yes, please explain (e.g. inability to meet cost, performance, or delivery schedules -also include contract number, name, address, and phone number of Terminating

Contracting Officer).

2.

What was the Contractor’s greatest strength in the performance of the contract?

3.

What was the Contractor’s greatest weakness in the performance of the contract?

4.

Would you award another contract to this Contractor? (Circle One Response)

Yes No

COMMENTS FOR EXCELLENT OR UNACCEPTABLE RATINGS:

ANY ADDITIONAL COMMENTS:

PART FOUR: EVALUATOR’S CERTIFICATION

I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

SIGNATURE OF EVALUATOR

TITLE OF EVALUATOR

DATE