ATTACHMENT 2 - PAST PERFORMANCE QUESTIONNAIRE
 
PART ONE:  INSTRUCTIONS

The company who has provided you this form is proposing on an Internal Revenue Service (IRS) Facility Operation & Maintenance Service contract (e.g. management, operation, preventative maintenance & repair for buildings, structures, grounds, utilities and related support systems)  Past performance is an important evaluation criterion for the acquisition, so input from previous customers of the offeror is very important.  We would greatly appreciate you taking the time to complete this form.  Note: Offerors may be debriefed on performance evaluation information obtained from references.  However, the names of the individual(s) providing information will not be disclosed.

Please provide your honest assessment and return the completed form (or equivalent) directly to the IRS Contracting Officer in time for evaluation beginning on or about (offeror is to insert date listed on solicitation page 1, SF33, block 9, unless proposal due date is otherwise amended): 
Ms. Linda Bender
         	Internal Revenue Service
          	Southeast Area Procurement Operations
2888 Woodcock Blvd. Suite 300, Stop 80-N
          	Atlanta, GA  30341
Phone:  (404) 338-9210; fax:  (404) 338-9231; or E-Mail: linda.bender@irs.gov  

PART TWO:  GENERAL INFORMATION
  
1.  OFFEROR’S NAME AND ADDRESS                                              2.  CUSTOMER ORGANIZATION	
                                                                                                                          NAME AND ADDRESS
     ______________________________________                                        ___________________________________

    _______________________________________                                       ___________________________________

    _______________________________________                                       ____________________________________ 

3.  CONTRACT NUMBER:  ________________                                  2a.  EVALUATOR

4.  ANNUAL CONTRACT VALUE (Check One):                                      NAME:  ___________________________

    ___<$1M; ___ $1-10M; ___ $10-20M; ___$>$20M                                 TITLE:  ___________________________
                                                                                 
                                                                                                                         PHONE NO: _______________________
								
5. CONTRACT OR ORDER AWARD DATE:                       6.  CONTRACT OR ORDER COMPLETION DATE
                                                                                                                             (Include Extensions):

                         _____/ _____/ _____                                                                   ____/ _____/_____

7.  CONTRACT TYPE (Check All That Apply):                                       8. COMPLEXITY OF WORK 
                                                                                                                         (Check One Response):
    ___Firm-Fixed Price                                                                                              
    ___Cost-Plus/Fixed Fee                                                                                  ___Difficult    ___Routine     ___Both
    ___Cost Plus Adjustable Fee
    ___Labor Hour/Time-and-Materials   Other:  Specify:  ________                                                      

 

PART TWO:  GENERAL INFORMATION (continued)
 
 9.  INDICATE GEOGRAPHIC DISTRIBUTION OF SERVICES      10.  NUMBER OF USERS                                                                                                                  
                                                                                                                        /LOCATIONS SERVICED 
     __ Local;   __ Nationwide;   __Worldwide                                                BY THIS CONTRACT:  ___                                                          

•	 TYPE AND EXTENT OF SUBCONTRACTING SUPPORT (Complete this item only if subcontracting support was used by the offeror):

•	BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

PART THREE:  OFFEROR PERFORMANCE RATING

Please rate the offeror’s performance in each of the evaluation factors/subfactors listed on the following pages.    Determine the adjectival rating that most nearly represents your experience with this offeror and indicate your assessment by placing any “X” under the appropriate heading. 

Evaluation factors include:

a.	QUALITY OF SERVICES
b.	OFFEROR PERSONNEL
c.	TIMELINESS OF PERFORMANCE
d.	CUSTOMER SATISFACTION

Adjectival ratings are defined as follows:

    OUTSTANDING =          Offeror performance was technically acceptable and provided 
                                              significant, unusual, unique, or worthwhile features or benefits.

    SATISFACTORY =          Offeror performance met customer expectations or contract 
                                               requirements (i.e., demonstrated an acceptable understanding 
                                               of the requirements, provided an acceptable management and
                                               technical approach to tasks; and provided complete response 
                                               to customer needs)

    MARGINAL =                  Offeror performance could have stood improvement (i.e.
                                               demonstrated a marginal understanding of requirements
                                               and marginal approach to tasks).

    UNSATISFACTORY =     Offeror performance DID NOT meet customer expectations
                                                or contract requirements.

     NOT APPLICABLE =      Evaluation factor is not applicable. 

PART THREE:  OFFEROR PERFORMANCE RATING

A. QUALITY OF SERVICE	OUTST	SATIS	MARG	UNSATIS	N/A	
1.  Contractor’s overall performance and management of contract requirements						
2. Contractor’s ability to satisfy contract technical work requirements 						
3.  Contractor’s process for controlling work ( receiving, validating, scheduling and tracking individual contract work requests)  						
4.  Contractor’s Quality Control System (ability to  identify and correct cause of non-conforming work or work processes)						
5.  Contractor’s Safety Program (record of safe operation)						
Comments: 

B.  OFFEROR PERSONNEL 	OUTST	SATIS	MARG	UNSATIS	N/A	
1.  Project Manager  (ability to effectively manage the contract)						
2.  Supervisors (ability to supervise contract work)						
3.  Contractor’s Work Staff, including Subcontractors (adequately trained; possess necessary skills; perform effectively in accordance with contract terms; etc.)						
Comments: 

C.  TIMELINESS OF PERFORMANCE 	OUTST	SATIS	MARG	UNSATIS	N/A	
1.  Timely contract start-up (acquired required licenses, training, administrative clearances,  equipment, etc. and prepared to start performance by contract start date)						
2.  Timely performance of contract work						
3.  Timely performance of administrative actions (e.g. submission of required reports, records, and other data submissions)						
4.  Timely payments (payroll and subcontractor payments)						
Comments: 

PART THREE:  OFFEROR PERFORMANCE RATING
				
D.  CUSTOMER SATISFACTION	OUTST	SATIS	MARG	UNSATIS	N/A	
1.  Contractor’s  commitment for providing resources as necessary to resolve user problems and questions						
2.  Contractor’s ability to  relate effectively to customer staff						
3.  Contractor’s ability to meet contract goals and objectives						
4.  Contractor’s positive and effective response to unexpected change and urgent requirements 						
	YES	NO	       UNCERTAIN	
5.  In your judgment, does the Contractor display integrity (appearing to adhere to a code of sound moral principals, uprightness, and honesty)?				
6.  WOULD YOU CONTRACT WITH THIS CONTRACTOR AGAIN FOR SIMILAR SERVICES?				
Comments:

COMMENTS: 

PART FOUR:  EVALUATOR 

The evaluation was performed by: 

Name/Title of Evaluator:____________________________  Signature of Evaluator: _________________________ Date:______________
Phone No. and Email Address _______________________________