Attachment 3 - Past Performance.doc

Bureau of Engraving and Printing

ATTACHMENT 4

SAMPLE TRANSMITTAL LETTER AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

{Date}

{Respondent’s Address}

W We have listed your firm as a reference for work we have performed for you as listed below. Our firm has submitted a proposal under a solicitation advertised by the Bureau of Engraving and Printing (BEP). In accordance with Federal Acquisition Regulations (FAR), the Bureau of Engraving and Printing (BEP) will complete an evaluation of our firm's past performance. Understand that while the responses to this questionnaire may be released FAR 15.306 (e) (4) prohibits the release of the names of the persons providing the responses, therefore, complete confidentiality will be maintained.

Please Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Your candid response to the attached questionnaire will assist the BEP’s evaluation team in this process.

Please send your completed questionnaire to the following address:

Bureau of Engraving and Printing Office of Acquisition A&E Construction Division Attn: Gordon A. Hackley 14th and C Streets, SW Washington DC 20228-0001 The questionnaires can also be e-mailed to gordon.hackley@bep.treas.gov If you have questions regarding the attached questionnaire, or require assistance, please contact Gordon Hackley, at 202-874-2226 or via email at the e-mail address listed above. Thank you for your assistance.

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

Upon completion of this form, please send directly to the Bureau of Engraving and Printing (BEP) Office of Acquisition, A&E Construction Division ATTN: Gordon Hackley by fax or e-mail, to the address shown below, no later than 3:00PM EST on 25 Sept 2009. Facsimile Number: (202) 874-3135. E-mail address: gordon.hackley@bep.treas.gov NOTE: Please Do not return this form to our offices.

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. LOCATION OF WORK: _______________________________

9. CONTRACT TYPE (Circle All That Apply):

8. COMPLEXITY OF WORK (Circle

One Response):

Fixed Price _____ Cost Reimbursement ____

DIFFICULT

ROUTINE

Other: (Specify) __________________

PART TWO: GENERAL INFORMATION CONTINUED

10. 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 subfactors with four possible adjectival ratings. Determine the adjectival rating that most nearly represents your experience with this offeror and indicate your assessment by placing an “X” under the appropriate heading. Offeror performance factors are:

A. CORPORATE COMMITMENT

B. QUALITY OF SERVICES/PRODUCT

C. TIMELINESS OF PERFORMANCE

Adjectival ratings are defined below and should be used as a reference in assessing performance:

OUTSTANDING

Contractors performance significantly exceeded the contract requirements.

GOOD

Contractors performance exceeded the contract requirements.

ACCEPTABLE

Contractors performance met contract requirements.

UNSATISFACTORY

Contractors performance was less than acceptable and was unable to perform contract requirements successfully.

N/A

Not applicable.

(a) subcontractors and suppliers

(b)labor force

(c) Cost

(a) Performance of services?

(b) Delivery of reports or other documentation?

PART THREE: OFFEROR PERFORMANCE RATING CONTINUED

1.

Has this contract been terminated for default?

YES

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?

4.

Would you award another contract to this contractor?

YES

No

COMMENTS:

OTHER REMARKS:

Please use the space below to provide other information related to the Contractor’s performance. This may include the contractor’s selection and management of subcontractors, and the flexibility in dealing with contract challenges.

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

DATE

PAGE