PastPerformanceQuestionnaire.docx

Solicitation # NIHOD2011281

National Institutes of Health

CONTRACT PERFORMANCE

RFP CUSTOMER SURVEY QUESTIONNAIRE

Please complete the following questionnaire and return via fax to 301-480-1203 or 301-480-1146 to the attention of Terita Stevenson or email this form to stevenst@od.nih.gov. Form must be returned by 08/16/11 at 2:15 pm ET directly from the evaluator.

Baseline Information

This survey pertains to the company:

Date of Survey:

Name of Person completing survey:

Your company/Agency:

Contract Number(s):

Your role in this contract:

Contracting Officer

Contract Specialist

Project Officer

Other : ______________________

Contract Award Date:

Contract Expiration Date:

Contract Value including all option and option periods

Type of Contract:

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

Subcontracting company names with Program Manager and phone numbers

General description of products/services required under the contract:

Rating Guidelines - Answers may be indicated with a or .

Quality of Product or Service

0 = Unsatisfactory 1 = Poor 2 = Fair 3 = Good 4 = Excellent 5 = Outstanding Unsatisfactory

Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements.

Poor

Overall compliance requires significant Agency resources to ensure achievement of contract requirements.

Fair

Overall compliance requires minor Agency resources to ensure achievement of contract requirements.

Good

There are no, or very minimal, quality problems, and the Contractor has met the contract requirements.

Excellent

There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government.

Outstanding

The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example for others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent".

Cost Control

Unsatisfactory

Ability to manage cost issues is jeopardizing performance of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, this level of ability to manage cost issues constitutes a significant impediment in consideration for future awards.

Poor

Ability to manage cost issues requires significant Agency resources to ensure achievement of contract requirements.

Fair

Ability to control cost issues requires minor Agency resources to ensure achievement of contract requirements.

Good

There are no, or very minimal, cost management issues and the Contractor has met the contract requirements.

Excellent

There are no cost management issues and the Contractor has exceeded the contract requirements, achieving cost savings to the Government.

Outstanding

The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where the contractor achieved cost savings and performance clearly exceeds the performance levels described as "Excellent".

Timeliness of Performance

Unsatisfactory

Delays are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards.

Business Relations

Unsatisfactory

Response to inquiries and/or technical, service, administrative issues are not effective. If not substantially mitigated or corrected it should constitute a significant impediment in considerations for future awards.

Poor

Response to inquiries and/or technical, service, administrative issues are marginally effective.

Good

Response to inquiries and/or technical, service, administrative issues are consistently effective.

Excellent

Response to inquiries and/or technical, service, administrative issues exceed Government expectation

Outstanding

The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent"

CUSTOMER SATISFACTION

The contractor is committed to customer satisfaction.

Would you select this firm again?

ADDITIONAL COMMENTS: