ATCH_5 _Past_Performance_Questionnaire_5.8.docx

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Request for Proposals
Solicitation number
SAQMMA14R0042
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ATT 5 Past Performance Questionaire

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PAST PERFORMANCE QUESTIONNAIRE

Your immediate attention is requested. Please submit this completed questionnaire directly to Christina Black, Contracting Officer, U.S. Department of State at blackce@state.gov, no later than COB July 17, 2014.

This questionnaire is associated with the following (check all applicable boxes):

|_| IDIQ Level, SAQMMA14R0042 |_| Task Order 1, PEO Services |_| Task Order 2, Food Services |_| Task Order 3, Fire Protection Services |_| Task Order 4, Medical Services |_| Task Order 5, RSO Support Services

Please complete this questionnaire based on the following guidance:

· Handwritten responses are sufficient.

· Indicate, based on the codes below, the contractor’s performance on the identified program. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels:

PERFORMANCE LEVEL
CODE
EXCELLENT
(E)
Indicates that the contractor’s performance within the area of evaluation clearly exceeds contractual requirements.
SATISFACTORY
(S)
Indicates no problems exist in the area of evaluation or has only minor problems for which solutions are in hand.
MARGINAL
(M)
Indicates the area of evaluation contains an existing problem for which there is doubt whether the identified solution is adequate but the problem appears to be within the contractor’s ability to solve.
UNSATISFACTORY
(U)
Indicates a serious problem exists in the evaluation area which may be outside the contractor’s ability to solve. The contractor is in danger of not being able to satisfy contractual requirements and timely recovery in not likely.
NEUTRAL
(N/A)
Performance did not include such efforts or performance was not observed.

Please circle a letter corresponding to your rating or ‘N/A’ if you are unable to provide a rating for an area.

FOR ANY RATING BELOW SATISFACTORY, A CLARIFICATION AND EXPLANATION IS REQUESTED. IF MORE SPACE IS NEEDED, USE THE BACK OF THIS QUESTIONNAIRE.

You are urged to supplement your knowledge of the contractor’s performance with the judgment of others in your organization. In addition to completing the attached questionnaire for the identified program, we solicit your comments on other similar programs for which your activity has contracts with this offeror.

If you have any questions, please contact Christina Black at BlackCE@state.gov.

PROGRAM IDENTIFICATION

A.
Name of Contractor that this Questionnaire is in reference to:
B.
Contract Number:
C.
Contract Effort or Program Title:
D.
Contract Type (fixed price, etc.):
E.
Estimated Amount/Annual Volume of Service:
F.
Period of Performance:
G.
Brief Description of contract effort or task:

I. MANAGEMENT ABILITY

1.
The contractor provided experienced executives, including project manager and supervisors and replacements with the technical and administrative qualifications required to meet the contract requirements.
E

S M U N/A

Supporting Narrative:

2.
The contractor’s delegation of authority to project manager and supervisors met contract requirements.
E

S M U N/A

Supporting Narrative:

3.
The contractor provided adequate resources (personnel/ equipment) in each specialty necessary to fulfill contractual requirements.
E

S M U N/A

Supporting Narrative:

4.
The contractor was able to maintain adequate staffing levels to fulfill contractual requirements.
E

S M U N/A

Supporting Narrative:

ALiSS- Questionnaire Source Selection Sensitive SAQMMA14R0042

Attachment 5Page 1 of 7
5.
The contractor provided effective emergency response actions and corrective actions to cover incidents such as: disruption of utilities, accidents, material shortages, safety, security, and hazardous materials handling incidents.
E

S M U N/A

Supporting Narrative:

II. QUALITY CONTROL

1.
Contractor provided effective Quality/ Inspection procedures and personnel to meet contract requirements.
E

S M U N/A

Supporting Narrative:

2.
When deficiencies were reported, the contractor took effective corrective actions pursuant to their Quality Control procedures.
E

S M U N/A

Supporting Narrative:

3.
Contractor completed projects and subsequent corrective actions, including punch-list items, in a timely manner.
E

S M U N/A

Supporting Narrative:

4.
Overall quality of the services provided under the contract.
E

S M U N/A

Supporting Narrative:

III. COST/PRICE

1.
The contractor provided accurate and timely proposals for change orders.
E

S M U N/A

Supporting Narrative:

2.
The contractor implemented cost control measures and tracking that resulted in transparent, accurate, and timely cost reporting, if applicable.
E

S M U N/A

Supporting Narrative:

IV. GENERAL

1.
Compliance with contract terms and conditions.
E

S M U N/A

Supporting Narrative:

2.
Willingness to cooperate with and assist the customer in routine matters and when confronted by unexpected difficulties.
E

S M U N/A

Supporting Narrative:

3.
Business integrity and business conduct.
E

S M U N/A

Supporting Narrative:

4.
The contractor’s ability to meet special needs (such as expedited delivery or crisis support) for delivery requirements?

E S M U N/A

Supporting Narrative:

5.
The contractor’s ability to effectively manage, coordinate, and integrate subcontractors?

E S M U N/A

Supporting Narrative:

6.
Given the opportunity, would your organization enter another contractual relationship with this contractor in the future?
E

S M U N/A

Supporting Narrative:

V. RESPONSE INFORMATION

The following information will assist in the analysis of the data. This information will be kept confidential.

Name of evaluator:

Office symbol and address:

Phone:

Email:

Position/Title:

Length of involvement in Program/Contract:

Source of Information/ Documentation utilized to rate Performance Level:

Date Questionnaire Completed:

May we contact you to discuss/ validate ?

VI. COMMENTS

NOTE: Additional comments are appreciated:

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