Attachment III - Past Performance Questionnaire.docx

Attachment III: Past Performance Questionnaire

The prospective Offeror listed in Block 1 is submitting a proposal in response to a Department of Justice, Federal Bureau of Investigation solicitation for the acquisition of purchasing Standardized Lights and Sirens IDIQ. You have been identified as a performance reference for the below contractor.

The Federal Government values your input and greatly appreciates your willingness to thoughtfully complete this performance evaluation. Please provide candid responses.

The information that you provide will be used in the award of a federal contract, therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up. Please return the completed Questionnaire within five (5) business days of receipt. If you are unable to complete this form, please notify the company who sent this to you as soon as possible.

Please inform the company who sent you this past performance questionnaire if you will not be able to complete it and submit it by 01:00 PM EST on June 16, 2025. The quoter (vendor) must submit two positive past performance questionnaires to be considered for award.

If you do not have knowledge of or experience with the below company, please forward this questionnaire to an individual within the agency who does.

By law, the Government will not disclose the names of individuals providing reference information during discussions with contractors.

BLOCK 1/CONTRACTOR: (Insert Contractor’s name here)

PART I. BACKGROUND

A. Respondent Identification

Organization:

Address:

Name:

Title:

Telephone Number:

Email Address:

B. Contract Identification

Contract Award Date:

Contract Number:

Contract Type:

Contract Value (Including All Option Periods):

Contract Term (Years):

Description of Services / Scope of Work:

PART II. EVALUATION

Performance Grades:

Exceptional - Contractor’s performance significantly exceeded most or all contract requirements. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.

Satisfactory – Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

Marginal – Performance meets most contractual requirements. The contractual performance of the element or sub-element being assessed reflects a problem for which the Contractor has not yet identified corrective action or the Contractor’s proposed actions appears to be effective or has not been fully implemented.

Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problems(s) for which the Contractor’s corrective actions appear or were ineffective.

Non-Applicable (N/A) - Performance information not recent or relevant as defined in the Solicitation. Unable to provide assessment.

Please grade each of the areas below and provide meaningful feedback/comments based on your knowledge of how the contractor performs in each area. Both positive and negative feedback is encouraged.

A. Performance / Ability to meet the Requirements

Unsatisfactory Marginal Satisfactory Exceptional N/A

Additional Comments:

B. Adherence to Delivery Schedule / Timeliness of Product Deliverables

Unsatisfactory Marginal Satisfactory Exceptional N/A

C. Quality of Shipments - Ability to meet the requirements of shipping to include packing, marking, etc., and the overall quality of the delivery

Unsatisfactory Marginal Satisfactory Exceptional N/A

D. Based on the Contractor’s overall performance, would you select this firm again?

Yes No

If no, please explain:

E. General Comments. Please provide any additional relevant performance information.

PART III. RETURN INFORMATION

Please return the completed questionnaire electronically to:

krhaus@fbi.gov

Thank you, Katelyn Haus Regional Contracting Officer National Acquisition Programs Unit Finance & Facilities Division, Procurement Section