Tech exhibit 24 Performance Assessment Questionnaire.docx

DOCX document 36 KB Posted

Attached to
DLPT5 Full Range Test Item Development Federal contract opportunity
Solicitation number
W91QF425R0003
Issued by
Department of the Army Materiel Command Mission and Installation Contracting Command Fort Eustis

About this file

This is a Performance Assessment Questionnaire template used to evaluate contractor performance for federal contracts. The questionnaire includes rating definitions across four confidence levels (Substantial, Satisfactory, Limited, and No Confidence) and consists of three parts: contract identification, evaluation criteria, and return information. For telephone interviews, there is an additional record of interview section.

The evaluation criteria assess five key areas: compliance with specifications and workmanship standards, effectiveness of project management, timeliness of performance, cost control and forecasting, and commitment to customer satisfaction. Each area requires a confidence rating and detailed rationale. The questionnaire requires detailed information about the contract, contractor, and respondent, including contact information and contract specifics such as value, award date, and completion date. This template appears to be supporting solicitation W91QF425R0003 for DLPT5 test item development for the Defense Language Institute Foreign Language Center, though the questionnaire itself is a standard form that could be used for any federal contract performance evaluation.

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Text version

Performance Assessment Questionnaire

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does [and/or notify the Contracting Officer]. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions, or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Substantial Confidence

· Satisfactory Confidence

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

D. Effectiveness in Forecasting and Controlling Estimated Costs.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

F. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Title:

Date:

Telephone Number

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

Performance Assessment Questionnaire – Telephone Interview

Contractor: ____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________

POC:________________________Title: ________________________
(Name)(E.G. PCO/ACO/TM)

(Agency, Telephone No., E-mail & Facsimile No.)

If conducting a telephone interview:

“Hello, I am ______________________. I am calling in reference to Contract ____________________ with a company called ________________________. My questions will pertain to the contractor’s record of past, which is defined as within the past three years, and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. A summary of this discussion may be sent to you for your records.

Please provide examples and/or explanations, and utilize the following ratings:

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. EVALUATION (To be completed by Point of Contact – Respondent)

*Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

D. Effectiveness in Forecasting and Controlling Estimated Costs.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

F. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Title:

Date:

Telephone Number

E-mail Address:

PART II. RECORD OF INTERVIEW (To be completed by PPT Member)

( ) Discussed recentness and relevance of information

( ) Read summary to person contactedDate: ____________________
( ) Sent copy to person contactedDate: ____________________
______________________________________________________________
PPT Member SignatureTyped or Printed Name
______________________________________________________________
TelephoneFax

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