Past Performance Questionnaires-ATCH 3.doc

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Services to Compile13f List Federal contract opportunity
Solicitation number
SECHQ1-12-Q-T-021
Issued by
Securities and Exchange Commission

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SECHQ1-12-Q-T-021

Attachment 3

ATTACHMENT 3

PAST PERFORMANCE QUESTIONNAIRE

The United States Securities and Exchange Commission (SEC), Office of Acquisition intends to acquire necessary management and personnel to support the Securities and Exchange Commission’s (SEC) Division of Investment Management (IM) in providing services to the SEC in order to compile a 13F List which complies with the requirements of Section 13(f) and Rule 13f to be used by institutional investment managers in preparation and filing of Form 13F with the SEC (such lists, the “13F List”). In order to accurately evaluate the offeror’s past performance, your assistance is requested in obtaining and verifying the past performance history of this offeror.

Two forms are provided to complete the evaluation: 1) Performance Rating Form; and 2) Supplemental Comment Form. Upon completion of this form, please submit it as an e-mailed attachment to the Contract Officer, Gabriel G. Aviles, at Avilesg@sec.gov and Contract Specialist, Cheryl Greenfield at Greenfieldc@sec.gov. Please ensure the subject line of the e-mail reads “SECHQ1-12-Q-T-021 - Past Performance Questionnaire – Insert Evaluated Company’s Name.”

The following standards shall be used in arriving at the rating.

Outstanding
The Quoter’s record of past performance, as applicable, specifically relates to and suggests that SEC can expect superior performance and customer satisfaction for this effort with very low risk.
Very Good
The Quoter’s record of past performance, as applicable, specifically relates to and suggests that SEC may expect highly satisfactory performance and customer satisfaction for this effort with minimal risk.
Acceptable
The Quoter’s record of past performance, as applicable, specifically relates to and suggests that the SEC may expect satisfactory performance and customer satisfaction for this effort. The Quoter’s past performance record reflects minimal prior SEC experience and suggests some risk.
Marginal
The Quoter’s record of past performance, as applicable, suggests no prior experience and suggests that the Government may expect less than satisfactory performance and customer satisfaction for this effort. The Quoter’s performance record presents a high degree of risk.
Unacceptable
The Quoter’s record of past performance, as applicable, suggests that the Government may expect unsatisfactory performance and customer satisfaction for this effort. The Quoter’s performance record, as applicable, suggests a high degree of risk.
Neutral
A "Neutral" rating indicates a quoter without a record of past performance or for whom information on relevant past performance is not available.

Performance Rating Form

NAME OF COMPANY EVALUATED:

ADDRESS OF COMPANY EVALUATED:

CONTRACT NUMBER:

CONTRACT PERIOD OF PERFORMANCE:

CONTRACT VALUE:

CONTRACT TYPE:

CONTRACTING OFFICER NAME,

ADDRESS, FAX AND TELEPHONE NUMBER, AND EMAIL ADDRESS:

TYPE OF SERVICES PERFORMED (ACTIVITY):

NAME OF EVALUATOR, COMPANY/AGENCY, ADDRESS, FAX AND TELEPHONE NUMBER AND EMAIL ADDRESS
DATE EVALUATION PROVIDED

Additional Comment Form

Please provide any additional comments regarding your performance element ratings in the space below. Please add additional pages as necessary.

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