Sol 72011424R00003Attachment J.4_Past Performance Reference Form.docx.pdf

ATTACHMENT J.4 - PAST PERFORMANCE REFERENCE FORM

PAST PERFORMANCE REFERENCE FORM

USAID/Georgia is seeking relevant past performance information for a USAID solicitation, RFP Number : 72011424R00003 for which the selected offeror will provide technical assistance to i) Strengthen public policies and improved government services that protect Vulnerable Groups such as, but are not limited to, persons with disabilities; victims/survivors of gender based violence; vulnerable children; and the lesbian, gay, bisexual, transgender, queer, and intersex

(LGBTQI+) community in Georgia (collectively herein, “Vulnerable Groups”); ii) increase public awareness and support for the protection of Vulnerable Groups’ human rights and their economic, social, and political inclusion; and iii) strengthen civil society organizations’ capacity to effectively advocate for public policies that protect Vulnerable Groups, and to provide effective services.

Please provide some brief feedback and select one of the ratings for each of the sub-criteria below. A table of the definitions for each of the ratings is included on the last page of this form.

Please respond by sending this feedback directly to USAID/Georgia by email to mschronce@usaid.gov with cc to rcocaucasus@usaid.gov. Please label the Subject Line of the email as “PP Reference - USAID Protection & Inclusion Program.”

If you have any additional questions or comments, please feel free to email the points of contact identified above.

Thanks for your time in responding. Your feedback is greatly appreciated in assisting in the evaluation process.

Organization Name for Whom Providing Reference Activity/Program Name

Begin Date End Date Dollar Value of Contract/Award

Name of Individual Providing Reference Date Reference Provided mailto:mschronce@usaid.gov mailto:rcocaucasus@usaid.gov

Employer E-mail Address

1. Please rate your satisfaction with the quality of product or service, including consistency in meeting goals and targets.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

2. Please rate the timeliness of contract performance to include schedule, including the timeliness against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements and rating.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

3. Please rate the Contractor’s ability to control costs, including forecasting costs as well as accuracy in financial reporting and rating.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

4. Please rate the quality of business relations and overall management, addressing the history of professional behavior and overall business-like concern for the interests of the customer, including the contractor’s history of reasonable and cooperative behavior and rating.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

5. For prime offerors who are not small business concerns, please rate their utilization of small business concerns as subcontractors, including efforts in achieving small business participation goals and rating.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

6. Please rate their regulatory compliance, such as reporting in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, etc.

☐Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory

Comments:

RATING TABLE

Adjective Past Performance Definition

Exceptional The offeror’s performance of previously awarded relevant contract met contractual requirements and exceeded many to the government’s benefit. The company performed with very few or minor problems, for which corrective actions taken were, or are, expected to be highly effective. Performance of completed contracts was either consistently of the highest quality or exhibited a trend of becoming so. The offeror’s past performance record leads to an extremely strong expectation of successful performance.

Very Good The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded some to the government’s benefit. The company performed with some minor problems, for which corrective actions taken were or are expected to be effective. Performance of completed contracts was either consistently of high quality or exhibited a trend towards becoming so. The offeror’s past performance record leads to a strong expectation of successful performance.

Satisfactory The offeror’s past performance of previously awarded relevant contracts met contractual requirements. The company performed with some problems, for which corrective actions taken by the contractor were, or are expected to be, effective.

Performance of completed contracts was consistently of adequate or better quality or exhibited a trend toward becoming so. The offerors past performance record leads to an expectation of successful performance.

Marginal The offeror’s performance of previously awarded relevant contracts did not meet some contractual requirements. The contractor’s performance reflected some serious problems for which the contractor either failed to identify or implement corrective actions in a timely manner, or for which the correctible actions implemented were, or are expected to be, only partially effective. Performance of completed contracts was consistently of mediocre quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an expectation that successful performance might be difficult to achieve or that it can occur only with increased levels of government management and oversight.

Unsatisfactory The offeror’s performance of previously awarded relevant contracts did not meet most contractual requirements and recovery, if any, did not occur within the stated period of performance. The contractor’s performance reflected serious problems for which the offeror either failed to identify or implement corrective actions were mostly ineffective. Performance of completed contracts was consistently of poor quality or a trend toward becoming so. The offeror’s past performance record leads to a strong expectation that successful performance would not be achieved or that it can occur only with greatly increased levels of government management and oversight.

Neutral The offeror lacks a record of relevant or available past performance history. Based on this, there is no expectation of either successful or unsuccessful performance.