Attachment_IV_SATISFACTION_SURVEY.docx

Past Performance Satisfaction Survey

An Offeror has provided your contact information as part of their proposal’s past performance submission. Please fill out the below survey regarding the Contractor’s performance. Your response will be used as part of the past performance evaluation of the Offeror’s proposal under solicitation # XZ003-XZ996-3.

Client Name:

Phone Number:

Government/Company Name Email Address:

Contractor Name Contract Number:

Project Title:

Period of Performance:

Date of Completion:

Description of the services provided:

1. Quality of Work Performed: Rating ____

How would you rate the quality of the work performed by the Contractor?

1 = Exceeded Requirements 2 = Met Requirements 3 = Sometimes Met Requirements 4 = Did Not Meet Requirements 5 = Not Applicable

Comments:

2. Timeliness of Deliverables: Rating ____

How would you rate the contractor’s performance in submitting deliverables on-time?

1 = Exceeded Requirements 2 = Met Requirements 3 = Sometimes Met Requirements 4 = Did Not Meet Requirements

Comments:

3. Cost Control: Rating ____

How would you rate the contractor’s performance in controlling costs during their performance of the contract?

1 = Exceeded Requirements 2 = Met Requirements 3 = Sometimes Met Requirements 4 = Did Not Meet Requirements

Comments:

Comments:

4. Responsiveness: Rating ____ Please rate the contractor’s timeliness and quality of response to the client’s inquiries and concerns.

1 = Exceeded Expectations 2 = Met Expectations 3 = Sometimes Met Expectations 4 = Did Not Meet Expectations

Comments:

5. Overall Performance: Rating ____

Please rate the overall performance of this contractor.

1 = Exceeded Expectations/Requirements 2 = Met Expectations/Requirement 3 = Sometimes Met Expectations/Requirements 4 = Did Not Meet Expectations/Require-ments

Please state whether you would prefer to hire this contractor again and why or why not.

Overall Performance Comments:

DO NOT return this questionnaire to the contractor. It must be returned directly to GSA at rose.river@gsa.gov and sally.bockh@gsa.gov by the RFP closing date, February 11, 2013, in order for it to be considered in the evaluation.

Source Selection Information FAR Subparts 2.101 and 3.104