ATT_11_RFQ_VideoSurv_PPQ_07072016.docx

NAMA-16-Q-0003, Video Surveillance System Software and Expansion

ATTACHMENT 11

RELEVANT PAST PERFORMANCE QUESTIONNAIRE

Note: To be completed by your references and returned by your references to the Contract Specialist by the date specified. Failure to do so may result in rejection of your quotation.

Your organization has been identified for participation in the past performance evaluation on a current solicitation at the National Archives and Records Administration (NARA). This survey will be used to evaluate the past performance for the Vendor and contracting action identified below.

Your candid response to the questions is important to our evaluation effort and may affect the award outcome. Please indicate "N/A" in any area which is not applicable to work performed on your contracting action. The names of individuals supplying past performance information will remain confidential.

Please take a moment to complete the enclosed survey and email the completed and signed survey to the contact listed below by 12:01 PM CT on July 25, 2016. A representative of NARA may contact you to arrange a time for a phone interview to review the survey. If you have any questions regarding this survey please contact:

Mr. Kevin Schumacher Email: kevin.schumacher@nara.gov

The following information is being requested:

Contract/Task Order number: ___________________________

Vendor’s name, operating unit and address: _______________________________________

Type of contract/task order: _______________________________________________________________

Program Name: _______________________________________________________________

Contract/Task Order Initiation date: _________________________________________________________

Contract/Task Order completion date (including extensions): ____________________________________

Years Remaining: ____________________________

Describe any schedule changes and reasons for schedule changes (if any):

Award Amount: _______________________________________________________________

Current Contract/Task Order $ Value (including exercised options and extensions): _________________

Projected Final Contract $ Value (including exercised options and extensions):

Reason why Award Amount and Current or Projected Final Contract $ Value differ (if they differ): ____________________________________________________________________________________

Description of the work performed (include the size, scope, and complexity of the project):

Evaluators name, position, organization, and role on the contract/task order: _________________________

Evaluator’s phone # and email address: _____________________________________________

Number of month’s Vendor performance was monitored by evaluator: __________________

1. Please rate each item listed below (circling is preferable; Use “1” through “5” with “5” being outstanding and “1” being unsatisfactory; N/O (Not Observed)) and Provide Comments to identify Specific Strengths/Weaknesses in each area

A1. Quality of Products or Services: Assess the Vendor’s conformance to contract/task order requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

A2. Proficiency in:

A3. Management of Personnel: Assess the Vendor’s success in attracting, selecting and retaining personnel, supporting personnel, managing subcontractor staff, and replacing personnel when necessary.

Comments (List specific strengths and weaknesses):

B. Timeliness of Performance - Assess the timeliness of the Vendor against the completion of the contract, task orders, milestones, delivery schedules, administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Comments (List specific strengths and weaknesses):

C. Cost Control – Assess the Vendor’s effectiveness in forecasting, managing, and controlling contract/task order costs (*Do not rate this item for Firm Fixed Priced contracts/task orders).

Comments (List specific strengths and weaknesses):

D. Business Relations – Assess the integration and coordination of relationships needed to execute the contract/task order

Comments (List specific strengths and weaknesses):

2. Overall Assessment: (please circle)

Comments (List any major strengths and major weaknesses):

3. Has any adverse past performance information identified above been shared with the Vendor?

( ) Yes: Written or Oral?

Date__________

( ) No: NARA may provide the Vendor with an opportunity to respond to any adverse past performance information.

( ) N/A

4. Would you select this Vendor again?

( ) Yes

( ) No