Attachment_5_Past_Performance_Questionnaire.docx

ATTACHMENT 5 – PAST PERFORMANCE QUESTIONANAIRE

INSTRUCTIONS TO OFFEROR: The Offeror must submit this Questionnaire to the Project Customer/Employer for those projects identified in Attachment 3 to the POC of the Customer/POC to complete. Offerors should submit this Questionnaire to the POC as soon as practicable to ensure the POC has adequate time to complete and submit the form.

INSTRUCTIONS TO POC/EVALUATOR: The organization that has provided you with this form is submitting a proposal to the US Agency for International Development (USAID) to provide on-call emergency road operations and maintenance support on a firm fixed price basis.

Past performance is an important part of the evaluation criteria for this application, so your input is very important. The completed questionnaire must be submitted by email directly to: oaainfrastructure@usaid.gov with a copy to the Contracting Officer Ms. Alexis McGinness at AMcGinness@usaid.gov and A&A Specialist Ms. Wagma Orya at WOrya@usaid.gov. The completed question is due via email no later than October 16, 2016. If you have questions, please contact A&A Specialist Wagma Orya at WOrya@usaid.gov.

Part A: General Information Offeror's Name:

Project Name:

Project Contract/Agreement No.:

Customer/Employer Organization Name:

Evaluator Name and Position Title:

Evaluator Email and Phone Number:

Date Contacted:

Contract/Agreement Type (Firm Fixed Price; Cost Plus Fixed Fee; etc)

Contract Completion Date:

Location of Work Performed:

Contract Amount:

Was the Offeror a Prime or Subcontractor?

Prime

Subcontractor

Project Scope/Description:

Part B: Past Performance Assessment

Quality of Service

Were you satisfied with the Quality of the Contractor’s services?

Did the Contractor provide quality reports and documents (i.e., accurate current and complete)?

Was the Contractor able to solve contract performance problems without extensive guidance from Customer/Employer counterparts?

Did the Contractor respond to emergency situations to include staffing and responsiveness?

Was the Contractor consistent in meeting goals and targets?

Key Personnel and Staffing

Did the Contractor supply professional and qualified personnel?

Did the Contractor provide prompt and satisfactory changes in personnel when problems were identified?

Schedule and Timeliness

Did the Contractor adhere to the contact delivery schedule in the performance of services?

Did the contractor adhere to the contract delivery schedule in the delivery of repots and other documentation?

Did the Contractor adhere to the contract delivery schedule in retaining qualified staffing?

Were the Contractor’s efforts to contribute to improving schedule variance effective?

Management and Business Relations

Did the Contractor provide effective contract and project management?

Did the Contractor establish and maintain effective quality control standards and procedures?

Did the Contractor have professional behavior and overall business-like concern for the interests of the customer?

Was the behavior of the Contractor reasonable and cooperative?

Was the Contractor cooperative in remedying any problems?

Overall

Overall, how would you deem to Contractor’s performance?

Part C: Evaluator’s Additional Comments:

1. Were any problems encountered and corrective actions taken?

2. Describe any quality awards are certifications that indicate exceptional capacity to provide services.

3. Other Remarks

Part D: Evaluator’s Certification I hereby certify that the information in this form is accurate and complete to the best of my knowledge.

USAID Past Performance Questionnaire - 3 | Page