Word Version of Past Performance Questionnaire Attachment 03.doc

SECTION J – ATTACHMENT

· PAST PERFORMANCE QUESTIONNAIRE

Past performance information from the Offeror from existing and prior contracts will be used for both a responsibility determination and as an evaluation factor to determine whether the Offeror’s selection would provide the best value to the Government. The Government will focus on information that demonstrates the Offeror’s technical and managerial performance and customer satisfaction relative to the size and complexity of the contract work. Evaluators will review all questionnaire responses timely received and will consider the information provided in light of the similarity between the work performed and the objectives set forth in section C of this solicitation; when the referenced work was performed; any trends, if evident, in the contractor’s performance; the overall rating given the Offeror by each contract client reference; and any information known to the evaluators from other sources.

Only three (3) of the Offeror’s most recent clients shall be provided a questionnaire to complete. The contract work performed for the client receiving the questionnaire must be ongoing or have been completed within the past three (3) years, and the contract work must have been ongoing for at least one (1) year. To the extent possible, the Offeror should identify contract clients for whom the Offeror performed services substantially similar to the services required by section C of this solicitation. If the Offeror does not have three (3) client references, the Offeror shall identify as many references as possible. Contract client references may include the Federal government, agencies of state or local governments or commercial entities and the contract experience may have been as part of a team or joint venture.

INSTRUCTIONS TO THE OFFEROR

Each Offeror shall forward this Past Performance Questionnaire to no more than three (3) contract client references. To the extent possible, the Offeror should identify clients for whom, during the past three (3) years, the Offeror has performed work substantially similar to the work described in section C of this solicitation. Each reference must return the completed questionnaire by email to the Contract Specialist indicated at box 10 of the SF-33. The deadline for receiving this questionnaire also is set forth below. These completed questionnaires shall be used as part of the evaluation process during Phase I.

Past Performance Questionnaire

Agency: Pension Benefit Guaranty Corporation

Address: Procurement Department, Suite 1090

1200 K Street, NW

Washington, DC 20005

E-Mail:

Kvalevog.Fiorela@pbgc.gov

INSTRUCTIONS FOR COMPLETING THIS QUESTIONNAIRE

A representative of the client for whom the work is being performed or was performed shall complete all sections of this questionnaire. If the client receiving this questionnaire is a federal agency, then this questionnaire should be completed by the Contracting Officer’s Technical Representative (COTR).

Sections B and C of the questionnaire shall be completed using the rating schedule found below by choosing the adjective that best describes the contractor’s work. Check the box that describes the appropriate rating. If a specific question does not pertain to the contract, please respond to the question by noting that it is not applicable (“N/A”). When possible, please provide a brief explanation for the ratings in the comment area.

Section D shall be completed using the rating schedule found below or simply by checking the Yes or No bracket where appropriate. Please pay special attention to the question concerning the overall rating of the contractor. A brief explanation for rating in the comment area would be especially helpful.

Section E, including signature and date, provides essential contact information in the event that the Agency needs to clarify any comments provided.

The adjective rating scale for all sections is defined below:

Outstanding

The contractor’s past performance indicates a record of meeting client requirements with a high degree of success and high customer satisfaction.

Satisfactory

The contractor’s past performance indicates a record of meeting client requirements with a moderate degree of success and moderate customer satisfaction.

Unsatisfactory

The contractor’s past performance indicates a record of meeting client requirements with some degree of satisfaction and some degree of customer satisfaction.

PAST PERFORMANCE INFORMATION

A. CONTRACT INFORMATION

1. Name of the Contractor being evaluated

2. Is the Contractor a primary contractor or a subcontractor?

3. Contract number (if applicable): _______________________________________

4. Contract type (if applicable):

( ) Fixed Price ( ) CPAF

( ) Cost Reimbursement ( ) ID/IQ

( ) CPFF – Completion ( ) BOA

( ) CPFF – Term ( ) Labor Hour

( ) CPIF ( ) T & M

( ) Other: (Please specify: ________________________________________

5. Period of performance (include option years, if any):_______________________

6. Estimated annual contract amount or amount of annual services:_____________

7. Brief description of the contract services provided:

8.

Was the contract a performance-based contract? ( ) Yes ( ) No

9.

Did the contract include a ( ) Statement of Work, ( ) Performance Work

Statement or a ( ) Statement of Objectives?

10. Type of award: ( ) Competitive

( ) Non-Competitive

( ) 8(a)

( ) Other

11. Name and phone number of COTR or primary contact at the client organization:

B.

TECHNICAL PERFORMANCE

1. How effective was the Contractor in understanding the business requirements of your organization and integrating them with the technical requirements of the contract work?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory Comment__________________________________________________________

2. How technically qualified were the Contract personnel initially and throughout the contract?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory Comment_________________________________________________________

3. To what extent did the Contractor complete work and provide deliverables on time?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory

Comment__________________________________________________________

4. To what extent were the contractor reports and technical documentation accurate and complete?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory

Comment__________________________________________________________

5. To what extent did the Contractor identify and provide options for solving problems effectively and efficiently?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory Comment__________________________________________________________

6. To what extent did the Contractor use effective escalation procedures when problems arose?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory Comment__________________________________________________________

7. Given the Contractor’s options for solving problems, how successful was the Contractor in solving problems?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory Comment __________________________________________________________________

8. To what extent did the Contractor conform to the requirements or satisfy the objectives of the contract?

C. MANAGEMENT PERFORMANCE

1. To what extent was the Contractor able to recruit and maintain qualified and reliable personnel for the duration of the contract?

Rating: ( ) Outstanding ( ) Satisfactory ( ) Unsatisfactory

Was recruitment timely? ( ) Yes ( ) No

Was turnover rate low? ( ) Yes ( ) No Comment__________________________________________________________

2. To what extent was the Contractor able to manage the overall performance of the contract? Include consideration of such issues as planning, scheduling, monitoring, invoicing, and reporting.

3. To what extent was the Contractor effective in interfacing with your staff and other contractors and creating a successful team approach?

4.

To what extent did the Contractor coordinate, integrate, and provide for effective subcontractor management?

D. CUSTOMER SATISFACTION

1. How would you rate the Contractor’s ability to demonstrate a cooperative, business-like attitude and respect for the interests of your agency or company?

2. Has the Contractor ever been given a cure notice, show cause notice, suspension of progress payments, letters of direction, or other written notification of unsatisfactory performance or progress?

( ) Yes ( ) No

3. Have you ever terminated a contract with this Contractor on this or any other contract?

4. Were there any other problems on the contract in connection with this Contractor?

5. Given your comments on this questionnaire, how would you rate the over-all performance of the Contractor on this contract?

6. Would you recommend the Contractor for additional contracts?

7. Please use the following space to provide any additional information that you feel would be beneficial to PBGC in making its decision on the award of its contract to this Contractor.

Comment__________________________________________________________

E. CLIENT INFORMATION

The following information refers to the individual completing this questionnaire:

Name and Title (Printed)

Organization (Agency or Company)

Telephone Number

E-mail Address

Signature and Date

On or before the closing date, May 7, 2010 at 10:00am ET., the client shall send this questionnaire by e-mail to the Contract Specialist, Fiorela Kvalevog, kvalevog.fiorela@pbgc.gov, at the Pension Benefit Guaranty Corporation.

Please ensure that the contract specialist successfully receives this questionnaire by the identified date and time.

Thank you for your time and attention in completing the questions in this evaluation.

Fiorela Kvalevog

Contract Specialist Procurement Department Pension Benefit Guaranty Corp.

1200 K Street, N.W., Suite 1090

Washington, DC 20005

E-Mail: Kvalevog.Fiorela@pbgc.gov

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