PAST PERFORMANCE QUESTIONNAIRE 70B03C21R00000072.pdf

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company who has provided you with this form is proposing on a Department of Homeland Security, Customs and Border Protection solicitation. Past Performance is an important part of the evaluation criteria for this acquisition, so your input is very important. Please provide an honest assessment and return the questionnaire to the Contracting Officer.

PART TWO: GENERAL INFORMATION

1. OFFEROR’S NAME AND ADDRESS 2. CUSTOMER ORGANIZATION

3. CONTRACT NUMBER: 2a. EVALUATOR

4. CONTRACT VALUE: $ NAME:

TITLE:

PHONE NO:

5. CONTRACT AWARD DATE: 6. CONTRACT COMPLETION DATE:

7. CONTRACT TYPE: 8. COMPLEXITY OF WORK (Circle One Response):

DIFFICULT

ROUTINE

9. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

PART THREE: OFFEROR PERFORMANCE RATING

On the following pages, please summarize the offeror’s performance in each rating factors. Each factor has a set of sub-factors with four possible confidence ratings. Determine the confidence rating that most nearly represents experience with this offeror and indicate assessment by placing an “X” under the appropriate heading. Offeror performance factors are:

A. QUALITY OF SERVICES/REPORTS

B. PROJECT MANAGEMENT - RESOURCE ALLOCATION

C. TIMELINESS OF PERFORMANCE

D. COST EFFECTIVENESS

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Exceptional Performance EXCEEDED MOST contractual requirements.

The performance of areas being assessed was accomplished with few minor issues or concerns.

Very Good

Performance EXCEEDED SOME contractual requirements.

The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective

Satisfactory

Performance MET contractual requirements. The performance of the areas being assessed contained minor issues or concerns, for which corrective actions taken by the Contractor were effective.

Unsatisfactory Performance DID NOT MEET contractual requirements. The performance of the areas being assessed included serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

Not Applicable

A QUALITY OF SERVICE Exceptional Very Good Satisfactory Unsatisfactory N/A

1 The overall value of supplies or services provided?

2 Vendor conformed (or exceeded) contract requirements

Did the contractor provide quality reports and documentation (i.e., accurate, current and complete)?

B PROJECT MANAGEMENT Exceptional Very Good Satisfactory Unsatisfactory N/A

Did the contractor provide effective contract and project management?

Was the contractor able to solve contract performance problems without extensive guidance from counterparts?

Did the contractor supply adequate and qualified replacement personnel?

How effective has the contractor been in understanding and responding to user requirements?

Did the contractor establish and maintain effective quality control standards and procedures?

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C TIMELINESS OF

PERFORMANCE

Exceptional Very Good Satisfactory Unsatisfactory N/A

Did the contractor adhere to contract delivery schedules in the following areas:

(a) Performance of services?

(b) Delivery of goods?

(c) Delivery of reports or other documentation?

Were replacement personnel identified and assigned to the project in a timely manner?

PART THREE: OFFEROR PERFORMANCE RATING CONTINUED

1. Has this contract been partially or completely terminated for default or convenience?

YES Default or Convenience

NO

If yes, please explain (e.g. inability to meet cost, performance, or delivery schedules - also include contract number, name, address, and phone number of Terminating Contracting Officer -

TCO).

2. What was the contractor’s greatest strength in the performance of the contract?

3. What was the contractor’s greatest weakness in the performance of the contract?

D COST EFFECTIVENESS Exceptional Very Good Satisfactory Unsatisfactory N/A

To what extent did the contractor meet the cost estimate?

Did the contractor effectively plan work to ensure maximum effective utilization of resources?

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4. Would you award another contract to this contractor?

YES No

PART FOUR: EVALUATOR’S CERTIFICATION

I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND COMPLETE TO THE BEST OF MY

KNOWLEDGE.

SIGNATURE OF EVALUATOR

TITLE OF EVALUATOR

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