Past Performance Evaluation Questionnaire.docx
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- Solicitation number
- W81XWH21R0001
- Issued by
-
Department of the Army Medical Command
About this file
This document contains a past performance evaluation questionnaire for a contractor providing biomedical research application evaluation and support services. The questionnaire will be used to evaluate offerors submitting proposals in response to a solicitation from the Congressionally Directed Medical Research Programs and U.S. Army Medical Research and Development Command. It requests information on the contractor's name, references, descriptions of prior work, contract details including number, value, dates of award and completion, and ratings for performance elements such as understanding requirements, managing resources, meeting deadlines, and delivering high quality work. Offerors are asked to submit the completed questionnaire by the close of the solicitation.
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Attachment 09
PAST PERFORMANCE QUESTIONNAIRE
AND INSTRUCTIONS
PAST PERFORMANCE EVALUATION QUESTIONNAIRE INSTRUCTIONS
U.S. ARMY MEDICAL RESEARCH ACQUISITION ACTIVITY
Fort Detrick, MD
The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting proposals in response to a Congressionally Directed Medical Research Programs (CDMRP) Request for Proposals (RFP) for Biomedical Research Application Evaluation Support Services (BRAES). The information you provide will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s).
a. Please complete all sections of the attached questionnaire. Include your name and title, organizational address, e-mail address, telephone and fax number.
b. Include the contractor’s name and address, the title and/or description of the type of work performed the award number, the value of the contract (including options), the award and completion date of the project and the type of award/solicitation.
c. Use the rating scale found on the bottom left corner of the questionnaire to rate each performance element.
| d. | Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments. | |
| Clear handwritten | responses are sufficient. |
e. Please e-mail your response to the Contract Specialists listed at the bottom right corner of the questionnaire. Do not forward this document to any other point of contact.
Thank you for your time and participation.
YOUR NAME & TITLE
YOUR ORGANIZATIONAL ADDRESS
TEL NO. FAX:
E-MAIL:
CONTRACTOR’S NAME & ADDRESS
TITLE OF REQUIREMENT:
| CONTRACT TYPE: | |_| FIXED PRICE | |_| COST + FEE | |
| |_| COMPETITIVE | |_| NON-COMPETITIVE |_| SET-ASIDE | ||
| |_| SEALED BID | |_| NEGOTIATED |
CONTRACT NUMBER:
CONTRACT VALUE (INCLUDING OPTIONS):
CONTRACT AWARD & COMPETION DATE:
DESCRIPTON OF REQUIREMENT:
| PAST PERFORMANCE ELEMENT |
| RATING |
| COMMENTS |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| NA |
| 1. | Contractor demonstrated a thorough understanding of | technical requirements of the contract/task. |
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| 2. | Contractor anticipated/identified and resolved problems | effectively. |
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| 3. | Contractor managed and directed resources (i.e. personnel, | subcontractors, equipment, etc.) effectively. |
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| 4. | Contractor provided the necessary skilled personnel to | perform the required work. |
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| 5. | Contractor retained the necessary skilled personnel and | maintained a low turnover rate. |
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| 6. | Contractor met scheduled contract delivery dates. |
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| 7. | Contractor provided accurate, complete and high quality | deliverables. |
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| 8. | Contractor complied with the terms of the contract. |
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| 9. | Contractor was diligent in forecasting and controlling | contract cost. |
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| 10. I would hire this contractor again. |
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| 1 |
| 0 – 25% of the time |
| Strongly Disagree |
| PLEASE RETURN COMPLETED RESPONSE TO: |
U.S. Army Medical Research Acquisition Activity Fort Detrick, MD 21702-5014 E-MAIL: abraham.g.pottenger.civ@mail.mil & deanna.s.moose.civ@mail.mil Due Date: By close of solicitation
| 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
FOR OFFICIAL USE ONLY – SOURCE SELECTION SENSITIVE WHEN COMPLETED
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