Sol_Doc_75F40124R00003_Attachment 11 - Past Performance Questionnaire.docx

75F40124R00003 Occupational Health Services IDIQ Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

Please complete the following questionnaire and return via email: Please reference “Past Performance Questionnaire, Solicitation No. 75F40124R00003” in the subject line. Send to the Contract Specialist, Noah Wills at Noah.Wills@fda.hhs.gov, and cc the Contracting Officer, Gary Klaff at Gary.Klaff@fda.hhs.gov, by 10:00am (Eastern) on January 17, 2023. Please note: Should the due date for quotes be extended, the due date for Past Performance Questionnaires may also be considered extended to the same extended date and time.

The U.S. Food and Drug Administration intends to issue a single-award IDIQ to obtain services related to Occupational Health Services.

Your agency/business has been selected as a past performance reference. Please take a moment to complete this past performance questionnaire using the ratings described below to answer each question. You may provide additional information and comments as necessary. Please provide a justification for the ratings provided.

This survey pertains to Contractor: ________________________

Department/Component:

Contract Number: Date of Survey: ________________

Name of Person Completing Survey: ______________________________________

Your Company/Agency: ________________________________________________

Your Role in this Contract (circle one):

Contracting Officer Contract Specialist Project Officer Other

Contract Value (including options): $_________________________________

Performance Period: _____________________________________________ (Including option periods)

Type of Contract: (circle one) Fixed-price Time-and-Material Labor-hour Cost-reimbursement Other:

Approximate percentage of work being performed (or completed) by subcontractor(s): %

Information on subcontractor(s) (where more than 51% of work was completed by the subcontractor):

________________ Subcontractor Program Manager Phone

________________ Subcontractor Program Manager Phone

General description of products/services required under the contract:

RATINGS

Please answer each of the following questions with a rating that is based on objective measurable performance indicators to the maximum extent possible. Commentary to support rating shall be noted on page 4.

Assign each area a rating of, 1 (Poor), 2 (Fair), 3 (Good),or 4 (Excellent). Use the Rating Guidelines (see end of document) as guidance in making these evaluations. Circle the appropriate rating. If you do not have enough personal knowledge or feedback from internal customers who directly received products and services from the contractor to make a determination on any of the performance criteria below, please circle "N/A" (not applicable/no opinion).

BUSINESS RELATIONS

1. Contractor provides knowledgeable, experienced, trained and qualified personnel.

1 2 3 4 N/A

2. Effective management, including management of subcontracts 1 2 3 4 N/A

3. Reasonable/cooperative behavior 1 2 3 4 N/A

4. Responsive to contract requirements 1 2 3 4 N/A

5. Notification of problems 1 2 3 4 N/A

6. Flexibility 1 2 3 4 N/A

7. Pro-active vs. reactive 1 2 3 4 N/A

QUALITY OF SERVICE

1. Compliance with contract requirements 1 2 3 4 N/A

2. Contractor is responsive to technical direction.

1 2 3 4 N/A

3. Accuracy of reports 1 2 3 4 N/A

4. Effectiveness of personnel 1 2 3 4 N/A

5. Technical Excellence 1 2 3 4 N/A

COST CONTROL

1. Record of forecasting and controlling target costs 1 2 3 4 N/A

2. Current, accurate and complete billings 1 2 3 4 N/A

3. Relationship of negotiated costs to actuals 1 2 3 4 N/A

4. Cost efficiencies 1 2 3 4 N/A

TIMELINESS OF PERFORMANCE

1. Met interim milestones 1 2 3 4 N/A

2. Reliability 1 2 3 4 N/A

3. Responsive to technical direction 1 2 3 4 N/A

4. Completed on time including wrap-up and contract administration 1 2 3 4 N/A

5. Contractor Met contract delivery schedules/deadlines 1 2 3 4 N/A

6. Contractor provided sufficient notification of contract problems to appropriate government personnel.

1 2 3 4 N/A

7. Contractor is pro-active and is reasonable/cooperative 1 2 3 4 N/A

8. Liquidated damages assessed: Yes No (circle one)

CUSTOMER SATISFACTION

1. The contractor is committed to customer satisfaction. Yes No (circle one)

2. Would you recommend this contractor for award (Yes or No)? Yes No (circle one)

Please explain.

3. Are you satisfied with the service you received and would you hire the contractor again (Yes or No)? If not, why not? Please be specific.

4. Do you feel the quality of the services received was worth the cost/price? Please circle one of the statements below.

A). Extremely well worth the cost.

B). Well worth the cost.

C). Worth the cost.

D). Cost was more than the value received.

E). Cost was greatly in excess of value received.

F). Government derived no value from cost spent.

ADDITIONAL COMMENTS:

RATING GUIDELINES

QUALITY OF PRODUCT OR SERVICE

COST CONTROL

TIMELINESS OF PERFORMANCE

BUSINESS RELATIONS

1-Poor

Major problems have been encountered

Contractor is having major difficulty managing costs effectively

Contractor is having major difficulty meeting milestones and delivery schedule

Response to inquiries, technical/ service/ administrative issues is marginally effective

2-Fair

Some problems have been encountered

Contractor is having some problems managing costs effectively

Contractor is having some problems meeting milestones and delivery schedule

Response to inquiries, technical/ administrative issues is somewhat effective

3-Good

Minor inefficiencies/ errors have been identified

Contractor is usually effective in managing costs

Contractor is usually effective in meeting milestones and delivery schedule

Response to inquiries, technical/ administrative issues is usually effective

4-Excellent

Contractor is in compliance with contract requirements and/or delivers quality products/services

Contractor is effective in managing costs and submits current, accurate, and complete billings

Contractor is effective in meeting milestones and delivery schedule

Response to inquiries, technical/ administrative issues is effective