Past Performanc Evaluation Questionnaire.docx

1. Contract Identification: (to be completed by offeror) Off eror Name and Address, Offeror Point of Contact Name/Title, Telephone Number, and E-Mail Address:

Ref erence (client) Inf ormation: Agency/Company Name and Address, Agency Point of Contact Name/Title, Telephone Number and E-Mail Address, for/ to whom this questionnaire was submitted:

Contract information for which this questionnaire was submitted:

Contract Number: Contract Type: Period of Performance: Total Contract amount: Location of Work:

Description of Work, scope, and responsibilities:

Relevance of the referenced contract to the current requirement:

Problems encountered in performance and corrective actions taken:

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Solicitation Number: 75F40125Q00337

Company’s capacity served on the project, i.e., prime, subcontractor etc.

2. Agency/Company Identification: (to be completed by Client)

Description of Work Performed and the Contractor’s Association with the Project (Prime, Subcontractor, etc.)

3. Contractor Performance Ratings:

https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Evaluation +Areas Please rate the Contractor’s performance by utilizing the rating and definition provided below. For the FDA to fully assess performance, it is imperative that ratings be accompanied by supporting narrative (comments):

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.

Satisfactory 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 appear or were satisfactory.

To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than Satisfactory solely for not performing beyond the requirements of the contract/order

Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

Unsatisfactory 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 To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

Please evaluate the following areas:

1. Quality of Product or Service (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Quality)

Rating Narrative:

2. Schedule (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Schedule)

Rating Narrative:

3. Cost Control (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Cost+Cont rol)

Rating Narrative:

4. Management Business Relations/Key Personnel https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Manageme nt

Rating Narrative:

5. Small Business Subcontracting (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Small+Bus iness)

Rating Narrative:

6. Regulatory Compliance (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Regulatory)

Rating Narrative:

7. Other Areas (https://cpars.cpars.gov/cpars/common/helpinfo_input.action?module=cpars&scope=de&topic=Other+Are as)

Rating Narrative:

8. Is/was the contractor committed to customer satisfaction?

· Yes

· No Narrative:

9. Would you hire this contractor to provide products/services for your organization in the future?

· Yes

· No Please explain why or why not:

Evaluator Information: Name (please print):

Title:

Work phone number (including area code):

FAX number (including area code):

E-Mail address:

Signature: