A07_ATTACHMENT_7_-_Past_Performance_Questionnaire_(rev).doc
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- Attached to
- Clinical Trial Support Services Federal contract opportunity
- Solicitation number
- W81XWH19R0011
- Issued by
- Department of the Army Medical Command
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Attachment 7 - Past Performance Questionnaire (rev)
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Department of the Army
US ARMY MEDICAL RESEARCH ACQUISITION ACTIVITY
820 CHANDLER STREET
FORT DETRICK MD 21702-5014
MCMR-AAA-SA 23 Apr 2019
Dear Sir or Madam, The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting proposals in response to: Clinical Trial Support Services Solicitation No. W81XWH19R0011 for Walter Reed Army Institute of Research (WRAIR). The information you provide will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s).
Step 1: Please complete all sections of the below past performance questionnaire.
Step 2: Use the rating scale on the left of the questionnaire, please rate each performance element.
Step 3: Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments.
YOUR RESPONSE MUST BE RETURN TO MYSELF ONLY AND RECEIVED BY:
23 May 2019
My contact information is: Julie L. Burns at julia.l.burns3.civ@mail.mil, Contract Specialist for U.S. Army Medical Research Acquisition Activity (USAMRAA), located in Fort Detrick, MD.
THANK YOU!
ATTACHMENT 7 (rev)
PAST PERFORMANCE QUESTIONNAIRE
Your Name & JOB Title yOUR Organizational Address
TEL NO.
E-MAIL:
CONTRACTOR’S NAME & ADDRESS
TITLE OR DESCRIPTION OF REQUIREMENT:
CONTRACT NUMBER:
CONTRACT VALUE (Base + All Options):
CONTRACT TYPE:
FORMCHECKBOX
FIXED PRICE
FORMCHECKBOX
COST + FEE
FORMCHECKBOX
TIME & MATERIAL FORMCHECKBOX
LABOR HOURS
CONTRACT PERIOD OF PERFORMANCE:
EXTENT COMPETED:
SET-ASIDE FORMCHECKBOX
SOLE SOURCE
FULL & OPEN COMPETITION
| PAST PERFORMANCE ELEMENT |
| RATING |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| NA |
1.
Contractor demonstrated a thorough understanding of technical requirements of the contract/task.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
2.
Contractor anticipated/identified and resolved problems effectively.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
3.
Contractor managed and directed resources (i.e. personnel, subcontractors, equipment, etc.) effectively.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
4.
Contractor provided the necessary skilled personnel to perform the required work.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
5.
Contractor retained the necessary skilled personnel and maintained a low turnover rate.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
6.
Contractor met scheduled contract delivery dates.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
7.
Contractor provided accurate, complete and high quality deliverables.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
8.
Contractor complied with the terms of the contract.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
9.
Contractor was diligent in forecasting and controlling contract cost.
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
| 10. I would recommend award to this contractor again. |
| FORMCHECKBOX |
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
FORMCHECKBOX
Comments:
| 1 |
| 0 – 25% of the time |
| Strongly Disagree |
| PLEASE RETURN COMPLETED RESPONSE BY: Thursday, 23 May 2019. |
TO: Julia L. Burns at julia.l.burns3.civ@mail.mil
| 2 |
| 26 – 40% of the time |
| Disagree |
| 3 |
| 41 – 55% of the time |
| Somewhat Disagree |
| 4 |
| 56 – 70% of the time |
| Somewhat Agree |
| 5 |
| 71 – 85% of the time |
| Agree |
| 6 |
| 86 – 100% of the time |
| Strongly Agree |
NA
No Knowledge of This Element
COMMENTS:
PAGE
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