Attachment_D_Past_Performance_Questionnaire.docx

PAST PERFORMANCE INFORMATION

CONTRACTOR PERFORMANCE CUSTOMER SURVEY QUESTIONNAIRE

Please complete the following questionnaire and return it via email to the attention of the individuals named below:

Contract Specialist, Joshua Bedregal at joshua.bedregal@dhs.gov Telephone: 202-325-4109

This survey pertains to: __________________________________________________________ Department/Component: _________________________________________________________ Solicitation Number: ____________________________________________________________ Date of Survey: ________________________________________________________________ Name of Person Completing Survey: _______________________________________________ Signature of Person Completing Survey: _____________________________________________ Your Company/Agency: _________________________________________________________ Your Role in this Contract: _______________________________________________________ Survey Period of Performance: ____________________________________________________ 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.

Assign each area a rating of either 4 (Outstanding), 3 (Good), 2 (Acceptable), or 1 (Unsatisfactory). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. Annotate with N/A if not a rating consideration or inapplicable to the contract effort.

QUALITY OF PRODUCT OR SERVICE:

1. Compliance with contract requirements:

1 2 3 4 N/A

2. Accuracy of reports:

1 2 3 4 N/A

3. Level of knowledge, experience, and training of personnel:

1 2 3 4 N/A

4. Capability of personnel to perform required services:

1 2 3 4 N/A

5. Effectiveness of personnel in performing required services:

1 2 3 4 N/A

6. Overall quality of product/service:

TIMELINESS OF PERFORMANCE:

1. Reliability:

1 2 3 4 N/A

2. Responsive to technical direction:

1 2 3 4 N/A

3. Meets contract delivery schedules and/or task deadlines:

1 2 3 4 N/A

BUSINESS RELATIONS:

1. Effective management, including subcontracts:

1 2 3 4 N/A

2. Reasonable/cooperative behavior:

1 2 3 4 N/A

3. Responsive to contract requirements:

1 2 3 4 N/A

4. Notification of problems:

1 2 3 4 N/A

5. Flexibility:

1 2 3 4 N/A

6. Pro-active vs. reactive:

1 2 3 4 N/A

CUSTOMER SATISFACTION:

1. The contractor is committed to customer satisfaction:

a. Contractor Management Personnel (circle one) Yes No

b. Contractor Onsite Facility Personnel (circle one) Yes No

ADDITIONAL COMMENTS:

ATTACHMENT D

HSBP1012Q0150

Rating Guidelines