Past Performance Questionaire.doc

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Attached to
Global Antiterrorism Training Assistance (GATA) Federal contract opportunity
Solicitation number
SAQMMA09R0356
Issued by
Department of State Office of Acquisition Management

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Text version

PAST PERFORMANCE INFORMATION

RFP CUSTOMER SURVEY QUESTIONNAIRE

SEQ CHAPTER \h \r 1Please complete the following questionnaire and return via regular mail, fax or email to the attention of:

William (Ted) Schaeffer By: On or before March 31, 2010 (Name)

(Date) Address:

Department of State

DS/T/ATA – William T Schaeffer

Washington, DC 20520 (Fax Number): 571-226-9661 (Email): schaefferwt@state.gov

This survey pertains to: __________________________________

Department/Component: ___________________________________ Contract Number: _________________________ Date of Survey:

Name of Person Completing Survey:

Signature of Person Completing Survey:

Your Company/Agency:

Your Role in this Contract (circle one):

Contracting Officer Contract Specialist Project Officer Other Contract Value (including options): $ Performance Period:

(including option periods) Type of Contract:

Approximate percentage of work being performed (or completed) by subcontractor(s): %

SEQ CHAPTER \h \r 1Information on subcontractor(s) (where more than % of work was completed by the subcontractor):

Subcontractor

Program Manager

Phone

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. Commentary to support rating shall be noted on page 4.

Assign each area a rating of 0 (Unsatisfactory), 1 (Poor), 2 (Fair), 3 (Good), 4 (Excellent), or 5 (Outstanding). Use the attached Rating Guidelines as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the contractor to make a determination on any of the performance criteria below, please circle "N/A" (not applicable/no opinion).

QUALITY OF SERVICE

1.

Compliance with contract requirements

N/A

2.

Accuracy of reports

N/A

3.

Effectiveness of personnel

N/A

4.

Technical Excellence

N/A

TIMELINESS OF PERFORMANCE

Met interim milestones

N/A

2.

Reliability

N/A

3.

Responsive to technical direction

N/A

4.

Completed on time including wrap-up and contract administration

N/A

5.

Met delivery schedules

N/A

6.

Liquidated damages assessed: Yes No (circle one)

BUSINESS RELATIONS/PERSONNEL MANAGEMENT

1.

Effective management, including management of subcontracts

N/A

2.

Reasonable/cooperative behavior

N/A

3.

Responsive to contract requirements

N/A

4.

Notification of problems

N/A

5.

Flexibility

N/A

6.

Pro-active vs reactive

N/A 7.

Effective small/small disadvantaged business subcontracting program

N/A

CUSTOMER SATISFACTION

The contractor is committed to customer satisfaction.

Yes No (circle one) 2.

Would you recommend selection of this firm again?

Yes No (circle one)

ADDITIONAL COMMENTS

Rating Guidelines

QUALITY OF PRODUCT OR SERVICE
COST CONTROL
TIMELINESS OF PERFORMANCE
BUSINESS RELATIONS
0-Unsatisfactory
Contractor is not in compliance and is jeopardizing achievement of contract objectives
Contractor is unable to manage costs effectively
Contractor delays are jeopardizing performance of contract objectives
Response to inquiries, technical/

service/ administrative issues is not effective

1-Poor
Major problems have been encountered
Contractor is having major difficulty managing costs effectively
Contractor is having major difficulty meeting milestones and delivery schedule
Response to inquiries, technical/

service/ administrative issues is marginally effective

2-Fair
Some problems have been encountered
Contractor is having some problems managing costs effectively
Contractor is having some problems meeting milestones and delivery schedule
Response to

inquiries, technical/ service/ administrative issues is somewhat effective

3-Good
Minor inefficiencies/

errors have been identified

Contractor is usually effective in managing costs
Contractor is usually effective in meeting milestones and delivery schedule
Response to

inquiries, technical/ service/ administrative issues is usually effective

4-Excellent
Contractor is in compliance with contract requirements and/or delivers quality products/services
Contractor is effective in managing costs and submits current, accurate, and complete billings
Contractor is effective in meeting milestones and delivery schedule
Response to

inquiries, technical/ service/ administrative issues is effective

5-Outstanding: The contractor has demonstrated an outstanding performance level in any of the above four categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances when contractor performance clearly exceeds the performance levels described as "Excellent."

SEQ CHAPTER \h \r 1

PAGE

(Attachment 6)

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