PPQ_-_Attachment_D.docx

RRB17Q0001

EAP Services

ATTACHMENT D

PAST PERFORMANCE QUESTIONNAIRE

Contractor: ________________________________ Reference Organization: ___________________ Name of Contact: _________________________ Date: ___________________________________

Please check the box with the applicable response for the questions below.

1. Direct applicability:

The RRB is considering this contractor to provide Employee Assistance Program (EAP) services (24/7 web enabled, phone based accessibility, on-site counseling for behavioral health, family, domestic, alcohol/drug use/dependency, health education, etc…). Did this contractor perform this specific type of service for your organization?

☐ Positively yes, the referenced contractor provided virtually identical services ☐ Basically yes, the referenced contractor provided generally similar services ☐ The referenced contractor provided slightly related services ☐ The referenced contractor provided fundamentally different services

Comments:

☐ Very satisfied with every aspect of the service ☐ Relatively satisfied ☐ Neither satisfied nor dissatisfied ☐ Relatively dissatisfied ☐ Services were unacceptable

Comments:

3. Key personnel:

Overall, how satisfied were you with the qualifications of the personnel provided to fulfill the requirements of the Contract?

☐ Very satisfied with the personnel provided ☐ Relatively satisfied ☐ Neither satisfied nor dissatisfied ☐ Relatively dissatisfied ☐ Services were unacceptable

4. Which of the following statements is most representative of the contractor’s ability to resolve issues/problems (major or minor) during the life of your EAP services (please select one):

☐ There were limited to no contractor issues during the life of the contract.

☐ There were contractor issues during the life of the contract; however, they were minor in nature and when addressed with the contractor, resolution was expedient and accurate.

☐ Issues were encountered. Resolution was adequately responsive with some lingering and/or minor inaccuracies in the contractor’s approach to resolving the issue.

☐ Significant issues were encountered. While generally resolved, resolution was unnecessarily delayed and inaccuracies or inefficiencies existed.

☐ Issues were encountered and the contractor either would not or could not remedy the matter.

Comments:

5. Taking the entire project into account, would you use this contractor again?

☐ Yes, definitely ☐ Yes, but with certain reservations ☐ Possibly ☐ Never

Comments:

6. Quality of items:

What was the quality of the services you received from this contractor?

☐ Of the highest quality/far exceeded my quality expectations/requirements ☐ Exceeded my quality expectations/requirements ☐ Met my quality expectations/requirements ☐ Below my expectations/requirements in terms of quality ☐ Regularly failed to meet my expectations/requirements in terms of quality Comments:

☐ The contractor exceeded my expectations in terms of displaying initiative and adaptability ☐ The contractor generally met my expectations in terms of displaying initiative and adaptability ☐ The contractor somewhat met my expectations in terms of displaying initiative and adaptability ☐ The contractor regularly failed to meet my expectations in terms of displaying initiative and adaptability

Comments:

8. Reliability and timeliness of performance:

Was the contractor reliable and timely in their delivery and performance of the services provided?

☐ Yes ☐ Mostly Yes. There were a few unavoidable delays. However, I was satisfied with the overall performance.

☐ There were more than an expected number of delays. The performance was overall acceptable, however, there were some issues in the contractor’s performance.

☐ No. There were an unacceptable number of delays and I could not rely on the contractor.

Comments:

☐ Yes, in every situation ☐ Yes, in most situations ☐ There were more than an expected number of business/contract issues. Overall, the contractor was cooperative; however, the issues were more than expected and/or could not be resolved by the contractor.

☐ No. The contractor was uncooperative and/or unresponsive to business/contract matters.

Comments: