Attachment 0002 _ Performance Assessment Questionnaire .docx

Performance Assessment Questionnaire

[Questionnaire should include questions to assess compliance with FAR 52.219-8 and FAR 52.219-9.]

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 (Use this Question on Cost Reimbursement Type Contracts Only).

· 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):_________________________________

(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 (Use this Question on Cost Reimbursement Type Contracts Only).

· 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

Performance Assessment Questionnaire – Telephone Interview Summary Memorandum

RSA-ACC- AMSAM-LA

MEMORANDUM FOR (insert Contractor name)

SUBJECT: Performance Assessment Telephone Interview Report

1. Enclosed is a summary of your telephone conversation, (insert date), with a member of a Past Performance Team at this Command.

2. Please review and verify the accuracy of this report and e-mail or fax it to my point of contact listed below by (insert date). If we do not receive your response by the date indicated above, we will consider the summary of the discussion official.

3. We would like to thank you in advance for your time and assistance regarding this acquisition. If you have any questions or comments, please contact: (Insert name, title, phone number, email address, fax number).

Jill G. Freeman

CONTRACTING OFFICER

Encl