Past Performance Questionnaire_TIRWR-10-R-00013.doc

Past Performance Questionnaire

Contractor:_______________________________________________________

Contract Number:________________________

Contract Type:___________________________

Description of Service:____________________________________________________

Period of Performance:________________________________________

Contract Value at Award (including options):___________________

Current Contract or Contract Completion Amount:________________________ Performed as: ( ) Prime ( ) Subcontractor on contract mentioned above.

If a subcontractor, describe the company’s role in the overall project:

(TO BE COMPLETED BY THE CONTRACTOR PERFORMANCE EVALUATOR)

Company/Organization:___________________________________________________ Name:

Title:

Signature: ___________________________________ Date__________________

Contact Information:

Telephone: __________________________________________________________

Fax:

Email: ______________________________________________________________

Thank you for your time and cooperation.

Please return the completed past performance questionnaire to:

Internal Revenue Service

Western Area Branch (OS:A:P:B:W)

Attn: Ashley Loper 1301 Clay Street, Suite 810 S

Oakland, CA 94612-5217

Annotate: SOLICITATION: TIRWR-10-R-00013 on each page of the completed past performance questionnaire.

INSTRUCTIONS:

The following questions are of two types: YES/NO and RATING. Circle your answer to each question.

• The YES/NO questions should be supplemented with explanatory narrative if “YES” is circled.

• When responding to the RATING-type questions, choose the corresponding letter(s) that most accurately describes the contractor’s performance or situation. If the question is not applicable, circle “N/A”. Response to the RATING questions should be supplemented with explanatory narrative as will, if necessary.

RATING CATEGORY

E – EXCELLENT:

A rating of “EXCELLENT” means:

· EXCEEDED ALL stated requirements (i.e., performance met and significantly exceeded all contract requirements to the company’s benefit).

G – GOOD:

A rating of “GOOD” means:

· MET ALL stated requirements and EXCEEDED SOME stated requirements (i.e., performance met all contract requirements and exceeded some to the company’s benefit).

A – ACCEPTABLE:

A rating of “ACCEPTABLE” means:

· MET ALL stated requirements, DID NOT EXCEED ANY of the stated requirements (i.e., performance met all contract requirements and exceeded none to the company’s benefit).

M – MARGINAL:

A rating of “MARGINAL” means:

· FAILED TO MEET SOME stated requirements (i.e., performance did not meet all contractual requirements. There were significant problems during contract performance, although the contractor’s corrective actions were typically effective).

U – UNACCEPTABLE:

A rating of “UNACCEPTABLE” means:

· FAILED TO MEET ALL stated requirements (i.e., performance did not meet all contractual requirements. There were serious problems during contract performance for which the contractor’s corrective actions were ineffective).

*N - NOT APPLICABLE:

A rating of “NOT APPLICABLE” means:

· If the question is not applicable or the rater does not have sufficient knowledge to provide a rating for the specific item, circle “N/A”.

Quality of Services:

A. Did the offeror provide services conforming to contract requirements and standards of good workmanship?

YES

NO

Please rate the quality of workmanship.

E G A M U N/A

Please provide a narrative justification for this rating:

B. Did the offeror demonstrate effective employee management?

YES

NO

Please rate the quality of employee management.

E G A M U N/A

Please provide a narrative justification for this rating:

C. Did the offeror demonstrate honesty

Cost Control:

A. Were IDIQ task orders included in this contract?

B. Did the offeror provide cost estimates for IDIQ work prior to issuance of a task order for the work?

NO

N/A Please rate the quality of IDIQ work performed.

E G A M U N/A Please provide a narrative justification for this rating:

C. Did the offeror adhere to budget estimates on task orders issued?

YES

NO

Timeliness:

Did the offeror adhere to schedules including the administrative aspects of performance such as report submittals? YES

NO

Please rate the quality of report submittals.

E G A M U N/A

Please provide a narrative justification for this rating:

Business Relations:

A. Did the offeror demonstrate reasonable and cooperative behavior?

B. Did the offeror demonstrate a commitment to customer satisfaction and an overall businesslike concern for the customer?

YES

C. Would this reference use the offeror’s services again?

Are there any substantial past performance problems that the offeror exhibited that presented an unacceptable risk to the Government?