(Attachment_1_to_RFQ)_PAST_PERFORMANCE_QUESTIONNAIRE.DOCX

Attachment to Combined Synopsis/Solicitation # W9124N-19-Q-0020

PAST PERFORMANCE QUESTIONNAIRE

Security Monitoring and Maintenance Service, Seaside CA

I. INTRODUCTION:

This questionnaire is designed to collect past performance information on offerors competing for award of a contract for Security Monitoring and Maintenance Service.

Please complete the enclosed questionnaire and return it to the MICC-POM contracting office no later than (NLT) 26 April 2019. Forms are to be returned to the point of contact listed below directly from the company or person providing the past performance information.

For assistance with this form or to request an electronic copy please notify the name below. If you need more space than provided, please attach additional pages, insure that you reference the number/section of the form that the response corresponds with. Please include only relevant information. Responses will be treated as source selection sensitive. Return the questionnaire either by mail or email to the following address:

400 Gigling Road, Bldg 4385 Seaside, CA 93955-6771

II. CUSTOMER/CLIENT IDENTIFICATION:

The following information pertains to the organization and contract information of the customer completing the questionnaire:

Your company or agency name: ___________________________________

Name of contractor being evaluated: ________________________________

Your contract number: __________________ Total value of your contract: _______________________

Performance Period: ________________________ Option Periods: _____________________________

Brief description of services provided: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

III. EVALUATOR INFORMATION:

The following information pertains to the person completing this questionnaire.

Name/Title: __________________________________________________________________________ (e.g. Manager, House Keeper, etc.)

Organization: _________________________________________________________________________

Phone Number: _______________________________________________________________________

IV. EXPLANATION OF CODES:

In Section V below of this questionnaire we ask questions regarding your contractor’s performance. Please use the following ratings when rating the contractor’s performance:

CODE PERFORMANCE RATINGS

V. QUESTIONS CONCERNING PAST PEFORMANCE:

Place an “X” in the appropriate box next to the letter for each item on the questionnaire. Narrative statements are vital. Please provide a supporting narrative for each area. Attach additional pages if there is insufficient space in the comment space.

1. What level of supervision does your contract require?

Little |_| None |_| Other ____________________________

2. How would you rate the contractor’s overall performance?

E |_| V |_| S |_| M |_| U |_| N |_|

Please explain if rated less than satisfactory__________________________________________________

3. How would you rate the contractor’s timeliness in providing your services?

E |_| V |_| S |_| M |_| U |_| N |_|

Remarks: _____________________________________________________________________________

4. Has the contractor ever had a problem with meeting the timeliness standards of the contract?

Yes |_| No |_|

If timeliness is a problem, what was/were the cause(s) of delay? Has the contractor corrected the problem?

Comments for Question 4:

5. Rate the contractor’s ability to work with the various requirements.

E |_| V |_| S |_| M |_| U |_| N |_|

Comments for Question 5:

6. Rate the contractor’s professional knowledge and reliability during the performance period?

E |_| V |_| S |_| M |_| U |_| N |_|

Comments for Question 6: __________________________________________________________________________________________________________________________________________________________________________

7. Have you experienced any problems with contractor employees?

Yes |_| No |_|

Comments for Question 7:

8. Rate the contractor’s interaction with your organization; e.g. courteous, professional, proper sense of urgency to your needs.

E |_| V |_| S |_| M |_| U |_| N |_|

Comments for Question 8:

9. Has this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes |_| No |_| DEFAULT |_| CONVENIENCE |_|

If yes, explain (e.g., inability to meet cost, performance, or delivery schedules).

Comments for Question 9:

10. Did you make any significant changes in service or procedures during the life of the contract?

Yes |_| No |_|

If so, what were the changes? ____________________________________________________________________________________________________________________________________________________________________________

11. Given the choice, would you award to this contractor again? Yes |_| No |_|

Explain why you would not enter into another contract with this firm.