PAST PERFORMANCE QUESTIONNAIRE

You have been identified as a past performance reference for the
contractor indicated in Block 1 below for the contract indicated in
Block 2 below. This contractor is proposing on a U.S. Patent and
Trademark Office (USPTO) acquisition for IT Help Desk Services under
solicitation number DOC52PAPT0801020. We value your input and appreciate
greatly your willingness to thoughtfully complete this questionnaire.

[INSTRUCTIONS]{.underline}: (1) Please fully complete the questionnaire,
(2) Place in a sealed envelope which contains your agency's/company's
letter head, and (3) Return the sealed envelope to the contractor you
evaluated for inclusion in their proposal to be submitted to the USPTO
by the solicitation closing date. [CONFIDENTIALITY:]{.underline} The
USPTO will not disclose the names of individuals who provide past
performance reference information regarding the contractor identified in
Block 1 below. If you have any questions, please contact Becky Morehart,
USPTO Contracting Officer, via email at Becky.Morehart@uspto.gov.

+-----------------------------------------------------------------------+
| > Block 1. Contractor Name:                                           |
+-----------------------------------------------------------------------+
| > Block 2. Contract Number/Name/Identifier:                           |
+-----------------------------------------------------------------------+

**PAST PERFORMANCE CONTRACT INFORMATION**

Contractor/Division:

Program Title:

Contract Number:

Period of Performance:

Type of Contract:

Total Value of Contract:

**Type of Call Center/Contact Center services work contractor performed
for you on this contract:**

**CHECK ALL THAT APPLY**

  --- -------------------------------------------------------------------
      Provided customer service representatives to answer telephone
      inquiries.

      Provided customer service representatives to answer e-mail
      inquiries.

      Provided customer service representatives to handle in-person or
      "walk-up" inquiries.

      Provided call center management to support day-to-day operations

      Other (please describe)
  --- -------------------------------------------------------------------

####### 

####### CALL CENTER METRICS

**Please provide the following call center metrics as applied to the
operation supported by this contract. If a metric is not tracked or
measured, please mark it "N/A" (Not Applicable).**

+-------------------------------------+--------------------------------+
| **Telephone Interactions**          | ######### E-mail Interactions  |
+-------------------------------------+--------------------------------+
| Number of calls received (daily):   | Number of emails received      |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      | (daily):                       |
|                                     | \_\_\_\_\_\_\_\_\_\_\_\_\_     |
+-------------------------------------+--------------------------------+
| Number of calls                     | Number of e-mails received     |
| receiv                              | (an                            |
| ed(annually):\_\_\_\_\_\_\_\_\_\_\_ | nually):\_\_\_\_\_\_\_\_\_\_\_ |
+-------------------------------------+--------------------------------+
| Abandon rate %                      | Abandon rate %                 |
+-------------------------------------+--------------------------------+
| Service level : % in seconds        | Service level (turnaround      |
|                                     | time) : \_\_\_\_\_\_\_\_\_\_\_ |
+-------------------------------------+--------------------------------+
| Average call handle time: seconds   | Average per e-mail handle      |
|                                     | time: \_\_\_\_\_\_\_\_\_\_\_   |
+-------------------------------------+--------------------------------+
| Cost per call:                      | Cost per e-mail:               |
| \$\_\_\_\_\_\_\_\_\_\_\_            | \_\_\_\_\_\_\_\_\_\_\_\_       |
+-------------------------------------+--------------------------------+

**PLEASE CHECK THE COLUMN THAT MOST APPROPRIATELY REFLECTS YOUR
EXPERIENCE WITH THE CONTRACTOR AND PROVIDE COMMENTS THAT JUSTIFY THE
RATING SELECTED. ADDITIONAL PAGES MAY BE USED IF NECESSARY.**

+----------------------------+----+-------+-----+--------+--------+---+
| ### CUSTOMER SATISFACTION  | ## | ####  | #   | # B    | #      | # |
|                            | ## | # Abo | # A | elow A | Unacce | # |
|                            |  E | ve Av | ver | verage | ptable | # |
|                            | xc | erage | age |        |        | # |
|                            | el |       |     |        |        | # |
|                            | le |       |     |        |        |   |
|                            | nt |       |     |        |        | N |
|                            |    |       |     |        |        | / |
|                            |    |       |     |        |        | A |
+----------------------------+----+-------+-----+--------+--------+---+
| 1.                         |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 2.  1\. How would you      |    |       |     |        |        |   |
|     describe the           |    |       |     |        |        |   |
|     contractor's           |    |       |     |        |        |   |
|     commitment to customer |    |       |     |        |        |   |
|     satisfaction?          |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 3.  COMMENTS:              |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 4.                         |    |       |     |        |        |   |
+----------------------------+----+-------+-----+--------+--------+---+
| 5.                         |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 6.  2\. How well were your |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
|  expectations/requirements |    |       |     |        |        |   |
|     met? COMMENTS:         |    |       |     |        |        |   |
+----------------------------+----+-------+-----+--------+--------+---+
| 7.                         |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 8.  3\. How committed was  |    |       |     |        |        |   |
|     the contractor to      |    |       |     |        |        |   |
|     providing resources as |    |       |     |        |        |   |
|     necessary to resolve   |    |       |     |        |        |   |
|     problems?              |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 9.  COMMENTS:              |    |       |     |        |        |   |
+----------------------------+----+-------+-----+--------+--------+---+
| 10.                        |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 11. 4\. How well did the   |    |       |     |        |        |   |
|     contractor work with   |    |       |     |        |        |   |
|     project/contracting    |    |       |     |        |        |   |
|     officers and task      |    |       |     |        |        |   |
|     managers?\             |    |       |     |        |        |   |
|     For instance, how      |    |       |     |        |        |   |
|     cooperative was the    |    |       |     |        |        |   |
|     contractor when        |    |       |     |        |        |   |
|     problems were          |    |       |     |        |        |   |
|     encountered?\          |    |       |     |        |        |   |
|     - Prompt notification  |    |       |     |        |        |   |
|     of problems?\          |    |       |     |        |        |   |
|     - Reasonable,          |    |       |     |        |        |   |
|     cooperative, and       |    |       |     |        |        |   |
|     flexible?\             |    |       |     |        |        |   |
|     - Recommended viable   |    |       |     |        |        |   |
|     solutions?             |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 12. COMMENTS:              |    |       |     |        |        |   |
+----------------------------+----+-------+-----+--------+--------+---+
| 13.                        |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 14. 5\. How well did the   |    |       |     |        |        |   |
|     contractor understand  |    |       |     |        |        |   |
|     your mission and       |    |       |     |        |        |   |
|     priorities?            |    |       |     |        |        |   |
|                            |    |       |     |        |        |   |
| 15. COMMENTS:              |    |       |     |        |        |   |
+----------------------------+----+-------+-----+--------+--------+---+

<table>
<colgroup>
<col style="width: 40%" />
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<col style="width: 7%" />
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<col style="width: 11%" />
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<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 0%" />
</colgroup>
<tbody>
<tr class="odd">
<td><h3 id="quality-of-productsservices">QUALITY OF
PRODUCTS/SERVICES</h3></td>
<td colspan="3"><h4 id="excellent-1">Excellent</h4></td>
<td colspan="3"><h5 id="above-average-1">Above Average</h5></td>
<td colspan="3"><h2 id="average-1">Average</h2></td>
<td colspan="3"><h1 id="below-average-1">Below Average</h1></td>
<td colspan="3"><h1 id="unacceptable-1">Unacceptable</h1></td>
<td colspan="3"><h5 id="na-1">N/A</h5></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2"><p>6. How was the contractor’s quality of
products/services?</p>
<p>Contract Compliance, Appropriateness of personnel, and</p>
<p>Accuracy of Reports?</p>
<p>COMMENTS:</p></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><p>7. Assess the contractor’s knowledge of call center
industry</p>
<p>standards and best practices.</p>
<p>COMMENTS:</p></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><h3 id="personnel">PERSONNEL</h3></td>
<td colspan="3"><h4 id="excellent-2">Excellent</h4></td>
<td colspan="3"><h5 id="above-average-2">Above Average</h5></td>
<td colspan="3"><h2 id="average-2">Average</h2></td>
<td colspan="3"><h1 id="below-average-2">Below Average</h1></td>
<td colspan="3"><h1 id="unacceptable-2">Unacceptable</h1></td>
<td colspan="3"><h5 id="na-2">N/A</h5></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><ol start="16" type="1">
<li></li>
<li><p>8. Assess the contractor's ability to recruit, screen, assign
responsibility, train, retain, support and replace staff.
COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="18" type="1">
<li></li>
<li><p>9. Assess the contractor’s ability to identify and resolve
staffing issues.</p></li>
</ol>
<p>COMMENTS:</p></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="management">MANAGEMENT</h3></td>
<td colspan="3"><h4 id="excellent-3">Excellent</h4></td>
<td colspan="3"><h5 id="above-average-3">Above Average</h5></td>
<td colspan="3"><h2 id="average-3">Average</h2></td>
<td colspan="3"><h1 id="below-average-3">Below Average</h1></td>
<td colspan="3"><h1 id="unacceptable-3">Unacceptable</h1></td>
<td colspan="3"><h5 id="na-3">N/A</h5></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="20" type="1">
<li></li>
<li><p>10. How well did the contractor meet goals, objectives, and
unexpected changes in scope or requirements? COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><ol start="22" type="1">
<li><p>11. How well did the contractor anticipate and respond to
expected/scheduled changes in workload?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="24" type="1">
<li></li>
<li><p>12. How well did the contractor provide timely notification of
problems?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><ol start="27" type="1">
<li></li>
<li><p>13. How well did the contractor closely adhere to
contract/delivery schedules?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="30" type="1">
<li></li>
<li><p>14. How well did the contractor submit <u>timely</u> reports and
documentation?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><ol start="33" type="1">
<li></li>
<li><p>15. How well did the contractor submit <u>accurate</u> reports
and documentation?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="36" type="1">
<li></li>
<li><p>16. How effectively did the contractor manage staff to meet
established performance expectations?</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><h3 id="cost-management">COST MANAGEMENT</h3></td>
<td colspan="3"><h4 id="excellent-4">Excellent</h4></td>
<td colspan="3"><h5 id="above-average-4">Above Average</h5></td>
<td colspan="3"><h2 id="average-4">Average</h2></td>
<td colspan="3"><h1 id="below-average-4">Below Average</h1></td>
<td colspan="3"><h1 id="unacceptable-4">Unacceptable</h1></td>
<td colspan="3"><h5 id="na-4">N/A</h5></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="39" type="1">
<li></li>
<li><p>17. Assess contractor's innovative actions that reduced overall
Call Center costs.</p></li>
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><p>18. How well did the contractor control costs?<br />
- Within budget (over/under target costs)<br />
- Contractor provided current, accurate, and complete billings<br />
- Relationships of negotiated costs to actuals (cost efficiencies)</p>
<ol start="42" type="1">
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><ol start="43" type="1">
<li></li>
<li><p>19. How well did the contractor provide accurate and reasonable
estimates of cost?</p></li>
<li><p>COMMENTS:</p></li>
<li></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="3"><h3 id="overall-evaluation">OVERALL EVALUATION</h3></td>
<td colspan="3"><h4 id="excellent-5">Excellent</h4></td>
<td colspan="3"><h5 id="above-average-5">Above Average</h5></td>
<td colspan="3"><h2 id="average-5">Average</h2></td>
<td colspan="3"><h1 id="below-average-5">Below Average</h1></td>
<td colspan="3"><h1 id="unacceptable-5">Unacceptable</h1></td>
<td colspan="3"><h5 id="na-5">N/A</h5></td>
</tr>
<tr class="even">
<td colspan="3"><p>20. How would you rate the contractor’s overall
performance?</p>
<ol start="47" type="1">
<li><p>COMMENTS:</p></li>
</ol></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
</tbody>
</table>

21\. Would you award a contract to or hire this contractor again? YES
\_\_\_\_\_\_\_ NO \_\_\_\_\_\_\_

I HEREBY CERTIFY THAT THE INFORMATION PROVIDED IN THIS QUESTIONNAIRE IS
ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

CUSTOMER ORGANIZATION

NAME AND ADDRESS

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Evaluator's Printed Name Title/Role (e.g., Contracting Officer, COTR,
etc.)

Evaluator's Signature Date

Telephone No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fax No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Email: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_