Attch 3_Past-Present Perf Questionnaire.doc

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Relocation Mangement Services
Solicitation number
HSSS01-12-R-0007
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Past Present Performance Questionnaire

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PAST & PRESENT PERFORMANCE QUESTIONNAIRE

Contractor’s Name:

Contract Number:

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name:

Address:

Telephone Number:

Fax Number:

Point of Contact:

Project Title and Brief Description of Work:

Contract Number:

Dollar Amount:

Contract Period or Dates of Performance:

Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent:

Title:

Address:

Telephone Number:

Fax Number:

Point of Contact:

C. EMAIL COMPLETED QUESTIONNAIRE FORM TO:

kimberly.spangler@usss.dhs.gov No later than March 9, 2012, at 5:00 PM ET

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation.

PLEASE PROVIDE A NARRATIVE EXPLANATION IN REMARKS SECTION FOR ANY RATINGS OF M or U.

E
G
S
M
U
N
Exceptional
Good
Satisfactory
Marginal
Unsatisfactory
Neutral

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.
Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor:
E
G
S
M
U
N
1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
2.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.
3.
Delegated authority to project managers and supervisors commensurate with contract requirements.
4.
Assigned Team participated in solving significant problems.
5.
Followed approved quality control plan.
6.
Provided effective quality control and/or review procedures to meet contract requirements.
7.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
8.
Provided timely resolution of contract discrepancies.
9.
Identified problems as they occurred.
10.
Suggested alternative approaches to problems.
11.
Displayed initiative to solve problems.
12.
Developed realistic progress schedules.
13.
Met established project schedules.
14.
Provided timely resolution to problems.
15.
Was responsive to contract changes.
16.
Provided adequate project supervision.
17.
Are successful in contacting employees utilizing their services within the timeframes established in contract.
18.
Are successful in disbursing equity in accordance with the terms of the contract.
19.
Are successful in providing employees with guaranteed buyout offers within the timeframes established in the contract.
20.
Receive satisfactory or better ratings from employees utilizing their services.
21.
Cooperate with Government personnel after award.
22.
How would you rate the contractor’s overall performance?
23.
Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”
YES/NO
24.
Would you award another contract to this contractor? If not, explain in “remarks.”
YES/NO
25.
Is the contractor rated in CPARS?
YES/NO

Remarks:

HSSS01-12-R-0007

Attachment 3

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