Past Performance Questionnaire QSDM-J8-100438-N.docx

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Attached to
RFP RFP, QSDM-J8-100437-N Federal contract opportunity
Solicitation number
QSDM-J8-100437-N
Issued by
GSA Federal Acquisition Service

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Past Performance Questionnaire.

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QSDM-J8-100437-N History.xls XLS spreadsheet
Fill-in Certification QSDM--J8-100437-N.docx DOCX document
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PAST PERFORMANCE QUESTIONNAIRE

Solicitation QSDM-J8-100437-N Please complete this Questionnaire and e-mail or fax to Contract Specialist, Mark Mourlam E-mail: sean.dugan@gsa.gov FAX: 816-926-3678.

We are currently in the process of preparing our proposal for the General Services Administration, FAS, Solicitation Number QSDM-J8-100438-N, FSC 5110 Miscellaneous Cutting Kits. As part of our proposal, we have listed you as a reference on our performance for this type of product with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail or fax to Contract Specialist, e-mail sean.dugan@gsa.gov FAX: 816-926-3678.

Questionnaire is due to Sean Dugan no later than 4:00 PM Eastern Daylight Time on November 14, 2011. Questionnaire must be submitted directly to the Contract Specialist on company letterhead if faxed or emailed from a corporate email account.

If you will not be available on November 15, 2011 for verification of this past performance evaluation please indicate another POC for the contacting officer to contact.

Alternate POC name: ________________________________________

Alternate POC phone number: _________________________________

Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR:

Phone: Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract or Identifying Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance: ________________________________________________________ ______________________________________________________________________________

4. Brief description of items provided: _______________________________________________

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________ II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions –

The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL
Performance EXCEEDS MOST contractual requirements. The performance of areas being assessed was accomplished with few minor issues or concerns.
VERY GOOD
Performance EXCEEDS 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 MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.
MARGINAL
Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.
UNSATISFACTORY
Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.
NOT APPLICABLE (N/A)
Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Past Performance Evaluation

Question 1. Performance

What is your assessment of the Contractor’s ability to meet your requirements?

Exceptional
Very Good
Satisfactory
Marginal
Unsatisfactory
N/A

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide products in a timely manner?

Exceptional
Very Good
Satisfactory
Marginal
Unsatisfactory
N/A

Timeliness

Ability to Resolve Timeliness Problems

Question 4. Quality of Shipments

What is your assessment of the Contractor’s ability to meet requirements of shipping (including packing, marking, etc) and the overall quality of the delivery?

Exceptional
Very Good
Satisfactory
Marginal
Unsatisfactory
N/A

Quality of Shipments

Question 5. Overall Rating of Contractor’s performance

What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

Exceptional
Very Good
Satisfactory
Marginal
Unsatisfactory

General Comments:

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