Attachment_E_Past_Performance_Questionnaire.pdf

Memorandum Department of the Treasury, Bureau of the Fiscal Service

Division of Procurement Attachment E

TO: PROSPECTIVE REFERENCES

FROM: Gina Huffman, Lead Contracting Officer

DATE: March 30, 2015

SUBJECT: Solicitation TFSAAFRW15CI0006, Nursing Services: Past Performance Questionnaire

The Bureau of the Fiscal Service is conducting a proposal evaluation for the subject solicitation. The point of contact listed in the attached questionnaire has identified your office as a source to evaluate the contractor’s past performance and it also authorizes release of this information to our office.

The individual most knowledgeable of the Contractor’s day-to-day operations and overall condition of performance rendered should complete the survey.

Please complete the questionnaire as thoroughly as possible by indicating your ratings and providing comments wherever applicable. For any rating of Unsatisfactory (U), we request you provide an explanation.

Your time and effort in providing this information is greatly appreciated. The requested information is critical to our evaluation. Please complete and return the completed package as quickly as possible, but no later than April 21, 2015 at 2:00 PM ET. You may e-mail to purchasing@fiscal.treasury.gov with " TFSAAFRW15CI0006, ATTN: MH/GH" in the subject line, or fax it to 304-480-7204.

Any questions should be sent to purchasing@fiscal.treasury.gov attention MH/GH . Thank you for your cooperation and quick response to this request.

Quality of Product or Service Rating Guideline When responding to the descriptive statements, select the letter, which most accurately describes the contractor’s performance or situation.

Excellent The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example for others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent".

Acceptable Overall compliance requires minor Agency resources to ensure achievement of contract requirements.

Unacceptable Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements.

Not Applicable The contractor was not required to perform or this was not covered under this contract.

mailto:purchasing@fiscal.treasury.gov mailto:purchasing@fiscal.treasury.gov

Solicitation: TFSAAFRW15CI0006

Contractor Name:

REFERENCE: POINT OF CONTACT INFORMATION

1. Company Name:

2. Name:

3. Office:

4. Email/Telephone:

I. QUALITY OF PRODUCT OR SERVICE: E A U N/A

1. Compliance with contract requirements.

2. Appropriateness of personnel assigned.

3. Technical Excellence

4. Businesslike Contract Administration

5. Accuracy of services provided.

II. COST CONTROL: E A U N/A

1. The Contractor remained within budget (over/under target costs).

2. The Contractor submits current, accurate and complete invoices.

3. Unallowable costs not billed.

4. Cost efficiencies

III. TIMELINESS OF PERFORMANCE: E A U N/A

1. Contractor met established milestones/schedules to complete the task on time, as scheduled.

2. Contractor performed all work and was reliable.

3. Contractor responded to technical direction.

4. Contractor completed the requirement on time, including follow-up and contract administration.

5. Contractor had no liquidated damages associated with missed deadlines.

IV. PROBLEM RESOLUTION E A U N/A

1. Contractor anticipates and avoids or mitigates problems.

2. Contractor notified COR promptly of problems.

3. Contractor provided effective contractor-recommended solutions.

V. BUSINESS RELATIONS: E A U N/A

1. Contractor provided effective management.

2. Contractor submitted businesslike correspondence.

3. Contractor ensured responsiveness to contract requirements.

4. Contractor demonstrated reasonableness, cooperativeness, flexibility and pro-activeness.

5. Contractor provided effective customer service skills.

VI. OVERALL PERFORMANCE: E A U N/A

1. Rate the overall performance of this contractor. Would you rehire this contractor?

Additional Comments:

Quality of Product or Service Rating Guideline