Attachment 5-Past Performance Info. Customer Survey Questionnaire.doc

Attachment 5 SEQ CHAPTER \h \r 1PAST PERFORMANCE INFORMATION

NIH CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

SEQ CHAPTER \h \r 1Please complete the following questionnaire and return via email to the contract specialist, Mrs. Elizabeth Leslie at lesliee2@mail.nih.gov by at 2:00 PM EST.

This survey pertains to (service received title):

Department/Component:

Contract Number: Date of Survey:

Name 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: ( firm fixed price, labor hours, time and materials, cost reimbursement, etc?)

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

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. Commentary to support rating shall be noted on page 4.

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. Highlight 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

N/A

Customer comments:

2.

Accuracy of reports

N/A

Customer comments:

3.

Effectiveness of personnel

N/A

Customer comments:

4.

Technical Excellence

N/A

Customer comments:

COST CONTROL

Record of forecasting and controlling target costs

N/A

Customer comments:

2.

Current, accurate and complete billings

N/A

Customer comments:

3.

Relationship of negotiated costs to actuals

N/A

Customer comments:

4.

Cost efficiencies

N/A

TIMELINESS OF PERFORMANCE

Met interim milestones

N/A

Customer comments:

2.

Reliability

N/A

Customer comments:

3.

Responsive to technical direction

N/A

Comments:

4.

Completed on time including wrap-up and contract administration

N/A

Customer comments:

5.

Met delivery schedules

N/A

Customer comments:

6.

Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS

Effective management, including management of subcontracts

N/A

Customer comments:

2.

Reasonable/cooperative behavior

N/A

Customer comments:

3.

Responsive to contract requirements

N/A

Customer comments:

4.

Notification of problems

N/A

Customer comments:

5.

Flexibility

N/A

Comments:

6.

Pro-active vs reactive

N/A

Customer comments:

7.

Effective small/small disadvantaged business subcontracting program

N/A

CUSTOMER SATISFACTION

The contractor is committed to customer satisfaction.

Yes No Customer comments:

2.

Would you recommend selection of this firm again?

Yes No

ADDITIONAL COMMENTS