Past_Performance_Questionnaire_NEHRP_IDIQ_2013.doc

SOURCE SELECTION SENSITIVE

(SEE FAR 3.104)

RFP #SB1341-13-RP-0080

Template for Past Performance Information Questionnaire

PAST PERFORMANCE INFORMATION QUESTIONNAIRE FOR

SOLICITATION NO. SB1341-13-RP-0080

PART I: FOR COMPLETION BY OFFEROR

Instructions:

The Offeror shall complete all items set forth in this Part I for each past performance information reference and return the completed forms with the proposal.

The Offeror shall also coordinate with their identified references, supplying them with the completed Part I and a blank Part II for completion, sufficiently in advance of the due date identified in Part II. The Government may contact the Offeror’s references after proposals are received to obtain any Part II documents that are not submitted by the proposal due date and time and/or to discuss their submissions to ensure a clear understanding of their evaluation.

Name and address of company being evaluated:

Name of customer firm/agency for which the referenced work was performed:

Federal Government FORMCHECKBOX

Local/State Government FORMCHECKBOX

Address of customer firm/agency:

Name, title, employer, and contact information for individual providing reference:

Referenced contract/order number:

Period of performance for referenced contract/order:

Contract/order award date:

Contract/order amount (including options exercised):

Cost Plus Incentive Fee FORMCHECKBOX

Labor-Hour FORMCHECKBOX

Cost Plus Award Fee FORMCHECKBOX

Cost Plus Fixed Fee FORMCHECKBOX

Time-and-Materials FORMCHECKBOX

No FORMCHECKBOX

Description of the contract/order work:

Relevance of the contract/order work to the work described in RFP SB1341-13-RP-0080:

PART II: FOR COMPLETION BY OFFEROR’S PAST PERFORMANCE INFORMATION REFERENCE

Instructions:

References are asked to complete all items set forth in this Part II and should submit the completed form ELECTRONICALLY so that it is received no later than August 1, 2013 at 12:00 pm EST at:

Email: divya.soni@nist.gov

All submissions of this Part should reference Solicitation number SB1341-13-RP-0080 in the email Subject Line.

Background Information

Name of respondent:

Position and title:

Employer name:

Employer’s address:

Name of Contractor for which information is being provided:

Referenced Contract/Order Number for which information is being provided:

Basis of qualification to evaluate Contractor’s past performance:

Names of key Contractor personnel:

Evaluation

For each performance element identified below, references should evaluate performance of the firm or individual identified in Part 1 of this form. Where the reference lacks sufficient information to provide an evaluation for a particular performance element, this should be noted. Where any deficiency or unfavorable information is identified, the reference should identify any mitigating factors that may weigh in favor of the person/firm on whose behalf the reference is provided (i.e., problems due to causes outside the contractor’s control). An individual within your organization who is knowledgeable of the Contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the Contractor’s performance with the judgment of others within their organization, as applicable.

Date this questionnaire was completed:

Please provide answers to the questions listed below. When responding to the questions listed, provide the letter that most accurately describes the contractor’s performance or situation (see the “ratings” chart below for a description of each letter). For any marginal or unacceptable rating, please provide explanatory narratives in the “Remarks” section at the bottom of this questionnaire. These remarks need not be lengthy, just detailed. If more space is required, attach additional pages. Handwritten responses to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.

Definitions of Potential Ratings for Questions Below:

1) QUALITY OF REPORTS AND SERVICE

Contractor’s ability to meet technical requirements specified in contract

Contractor’s ability to effectively control the quality of reports and services provided

2) DAY-TO-DAY MANAGEMENT

Contractor’s ability to manage its financial and human resources to meet contract requirements

Contractor’s ability to effectively manage the contract/order from a contract administration standpoint

Contractor’s professionalism and business acumen

3) STAFF RETENTION

Contractor’s ability to retain key personnel to within reasonable levels of turnover

4) TIMELINESS

Contractor’s ability to meet timeliness requirements for contract deliverables

Contractor’s ability to meet schedule milestones when unanticipated events occur

5) COST CONTROL

Contractor’s ability to manage its resources within cost limitations set forth in the contract

Contractor’s ability to accurately track and report costs as required by the contract

6) MEETING PROJECT DEADLINES

Contractor’s ability to meet project deadlines in a multi-disciplinary, multi-project environment

OVERALL RATING:

Remarks: