Attachment_9_-_Past_Performance_Questionnaire.docx

SOL-HQ-14-00018 ATTACHMENT 9

ATTACHMENT 9 –

PAST PERFORMANCE QUESTIONNAIRE

STANDARD CONTRACTOR PAST PERFORMANCE QUESTIONNAIRE

This is a past performance questionnaire for The U.S. Environmental Protection Agency (EPA) to obtain past performance information on the contractor listed below. You should have received this questionnaire along with a Client Authorization Letter from the contractor listed below asking for your cooperation in completing this questionnaire. Information obtained in this questionnaire is for the sole purpose of evaluating the contractor’s past performance history to assist EPA in determining the best value for award of a contract resulting from our solicitation. As an evaluator, your participation in this questionnaire is greatly appreciated.

INSTRUCTIONS

To complete this questionnaire, the contractor should:

1. Complete the CONTRACT DATA section on Page 3.

2. Forward this questionnaire along with a Client Authorization Letter to the reviewer.

To complete this questionnaire, the evaluator should:

1. Review the CONTRACT DATA section on Page 3.

2. Review and complete the ADMINISTRATIVE INFORMATION section on Page 3.

3. Complete the EVALUATION FACTORS section starting on Page 5 using the RATINGS on Pages 3-4 based on the Contractor Performance Rating System (CPARS). Evaluate and assign a rating for Quality of Product or Service, Schedule, Cost Control, Business Relations, Management of Key Personnel, Utilization of Small business, and Customer Satisfaction. Include a narrative for each rating if appropriate.

4. Return the questionnaire to the U.S. EPA by email to uhr.danny@epa.gov by March 11, 2016.

QUESTIONS

If you have any questions about completing or submitting this questionnaire, please contact the Contract Specialist for this acquisition, Danny Uhr, at uhr.danny@epa.gov.

CONTRACT DATA

Contract Number:

Contractor Name:

Contract Title:

Contractor Address:

Contract Value:

Contractor DUNS:

Contract Type:

Contract Award Date:

Agency/Org. Name:

Reporting Period (Start):

Contracting Office:

Reporting Period (End):

TASK ORDER DATA (IF APPLICABLE)

Task Order Number:

Task Order Value:

Task Order Title:

Task Order Award Date:

Reporting Period (Start):

Task Order Type:

Reporting Period (End):

ADMINISTRATIVE DATA

Evaluator:

Contracting Officer:

Phone:

Phone:

Fax:

Fax:

Email:

Email:

Contractor Rep.:

Alt. Contractor Rep.:

Phone:

Phone:

Fax:

Fax:

Email:

Email:

(Next page)

RATINGS

The following ratings and definitions apply to the Quality of Product or Service, Schedule, Cost Control, Business Relations, and Management of Key Personnel factors:

The following ratings and definitions apply to the Utilization of Small Business factor:

EVALUATION FACTORS

1. Quality of Product or Service. Assess the Contractor's conformance to contract requirements, specifications and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

2. Schedule. Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or effect the schedule variance).

This assessment of the Contractor's adherence to the required delivery schedule should include the Contractor's efforts during the assessment period that contributes to or effect the schedule variance. This element applies to contract closeout activities as well as contract performance. Instances of adverse actions such as the assessment of liquidated damages, or issuance of Cure Notices, Show Cause Notices, and Delinquency Notices are indicators of problems which may have resulted in variance to the contract schedule and should therefore be noted in the evaluation.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

3. Cost Control (Not required for Firm Fixed Price or Firm Fixed Price with Economic Price Adjustment). Assess the Contractor's effectiveness in forecasting, managing, and controlling contract cost.

For example, does the Contractor keep within the total estimated cost (what is the relationship of the negotiated costs and budgeted costs to actuals)? Did the Contractor do anything innovative that resulted in cost savings? Were billings current, accurate and complete? Are the Contractor's budgetary internal controls adequate?

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

4. Business Relations. Assess the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor's history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

5. Management of Key Personnel (For Services and Information Technology Business Sectors only - Not Applicable to Operations Support). Assess the Contractor's performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

6. Utilization of Small Business (Not applicable if contractor is a small business or if the contract did not require a Subcontracting Plan)

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

7. Customer Satisfaction

Was the contractor committed to customer satisfaction?

Yes

No

Would you recommend the selection of this firm again?

Yes

No

Provide comments on Customer Satisfaction (2000 characters maximum):

Attachment 9 Page 7 of 7