J.6. Past Performance Questionnaire Survey.pdf

Page 1 of 4 Emergency Air and Ground Transportation 2024 75A50224R00022

ATTACHMENT J.6.

PAST PERFORMANCE QUESTIONNAIRE SURVEY

This survey pertains to (VENDOR NAME): ______________________

Department/Component: _____________________________________

Contract Number: ______________________

Date of Survey: ___________________

Name of Person Completing Survey: ______________________________

Signature of Person Completing Survey: ________________________________

Your Company/Agency: __________________________

Your Role in this Contract (circle one):

Contracting Officer Contract Specialist Project Officer Other ________________________

Contract Value (including options): $__________________________

Performance Period: __________________________________ (Including option periods)

Type of Contract: __________________________________

Approximate percentage of work being performed (or completed) by subcontractor(s): _________%

Information on subcontractor(s) (where more than ____% of work was completed by the subcontractor):

Subcontractor Program Manager Phone

Subcontractor Program Manager Phone

General description of products/services required under the contract: _______________________________________

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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 rating may be noted at the end of the questionnaire under ‘additional comments. Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent) or 5 (Outstanding). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the Contractor to make a determination on any of the performance criteria below, please circle “N/A” (not applicable /no opinion).

QUALITY OF SERVICE

1. Compliance with contract requirements 0 1 2 3 4 5 N/A

2. Accuracy of reports 0 1 2 3 4 5 N/A

3. Effectiveness of personnel 0 1 2 3 4 5 N/A

4. Technical excellence 0 1 2 3 4 5 N/A

COST CONTROL

1. Record of forecasting and controlling target costs 0 1 2 3 4 5 N/A

2. Current, accurate and complete billings 0 1 2 3 4 5 N/A

3. Relationship of negotiated costs to actuals 0 1 2 3 4 5 N/A

4. Cost efficiencies 0 1 2 3 4 5 N/A

TIMELINESS OF PERFORMANCE

1. Met interim milestones 0 1 2 3 4 5 N/A

2. Reliability 0 1 2 3 4 5 N/A

3. Responsive to technical direction 0 1 2 3 4 5 N/A

4. Completed on time including wrap-up and contract administration 0 1 2 3 4 5 N/A

5. Met delivery schedules 0 1 2 3 4 5 N/A

6. Liquidated damages assessed: Yes No (circle one)

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BUSINESS RELATIONS

1. Effective management, including subcontracts 0 1 2 3 4 5 N/A

2. Reasonable/cooperative behavior 0 1 2 3 4 5 N/A

3. Responsive to contract requirements 0 1 2 3 4 5 N/A

4. Notification of problems 0 1 2 3 4 5 N/A

5. Flexibility 0 1 2 3 4 5 N/A

6. Pro-active vs. reactive 0 1 2 3 4 5 N/A

7. Effective small/small disadvantaged business subcontracting program 0 1 2 3 4 5 N/A

CUSTOMER SATISFACTION

1. The Contractor is committed to customer satisfaction.

Yes No (circle one)

2. Would you recommend selection of this firm again?

Yes No (circle one)

ADDITIONAL COMMENTS

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RATING GUIDELINES

QUALITY OF PRODUCT OR

SERVICE

COST CONTROL TIMELINESS OF

PERFORMANCE

BUSINESS RELATIONS

0 – Unsatisfactory 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/admi nistrative issues is not effective

1 – Poor Major problems have been encountered

Contractor is having major difficulty in managing costs effectively

Contractor is having major difficulty meeting milestones and delivery schedules

Response to inquiries, technical/service/admi nistrative issues is marginally effective

2 – Fair Some problems have been encountered

Contractor is having some problems in managing costs effectively

Contractor is having some problems meeting milestones and delivery schedules

Response to inquiries, technical/service/admi nistrative issues is somewhat 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/admi nistrative issues is usually effective

4 – Excellent 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/admi nistrative issues is effective

5 – Outstanding: The Contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when Contractor performance clearly exceeds the performance levels described as “Excellent”.