Attachment_J-5_Past_Performance_Questionnaire.docx

REVIEWER: PLEASE SUBMIT COMPLETED FORM TO MARK.GREEN2@IRS.GOV.

ATTACHMENT J-5 PAST PERFORMANCE QUESTIONNAIRE

Name of Company being evaluated

Name of Entity/Agency/Firm for which Company being evaluated provided service

Questionnaire Respondent Name and Title

Questionnaire Completion Date

Period of Performance for which this evaluation covers

Detailed Description of Requirement

EVALUATION – Instructions to questionnaire respondent

Below are listed specific questions relating to the following five categories for contractor performance: quality, timeliness, cost control, business relations, and customer satisfaction. Please rate the contractor for each question on a scale from Excellent to Unacceptable or N/A for not applicable. There is a comment section provided below each question. Please document any responses receiving a rating of Unacceptable.

Excellent: Past Performance met contractual requirements and exceeded many to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Good: Past Performance met contractual requirements and exceeded some to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance met contractual requirements. The contractual performance contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Unacceptable: Past Performance did not meet contractual requirements and recovery was not timely. The contractual performance reflects serious problem for which the contractor did not identify corrective actions or the contractual performance contained serious problem(s) for which the contractor’s corrective actions were ineffective.

A. QUALITY OF PRODUCT OR SERVICE

1. To what extent did the contractor comply with the specific contract requirements?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

2. To what extent did the contractor provide quality best available science review?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

3. To what extent did the contractor provide quality scientific subject matter expertise?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

4. To what extent did the contractor identify additional/different scientific subject matter expertise than available in-house, if needed?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

5. To what extent did the contractor provide quality project management, including scheduling of resources and tracking status of deliverables?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

6. To what extent did the contractor provide quality project orientation materials?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

B. TIMELINESS OF PERFORMANCE

1. To what extent did the contractor adhere to contract delivery of performance schedules?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

2. To what extent did the contractor adhere to contract delivery of monthly reports?

3. Responsiveness and capability to respond to urgent/short term requirements.

C. BUSINESS RELATIONS

1. To what extent was the contractor able to solve contract performance problems without extensive guidance from Government counterparts (COR)?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

2. To what extent was the contractor effective in interfacing with Government staff?

D. CUSTOMER SATISFACTION

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

[ ] Yes for: [ ] Default [ ] Convenience [ ] Cause [ ] No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

2. Are there any pending terminations?

[ ] Yes [ ] No

If yes, please explain and indicate the status.

3. Would you recommend this contractor for the award of additional contracts?

[ ] Yes [ ] No

F. OVERALL PERFORMANCE

How would you rate the vendor’s overall performance?

[ ] Excellent [ ] Good [ ] Acceptable [ ] Unacceptable [ ] N/A

Comment:

Department of the Treasury Attachment J-5 Past Performance Questionnaire:

Request for Proposal #A15080