1.61c - Attachment 3 - Past Performance Report Form.docx_safe.pdf

PDF 91 KB Posted

Attached to
NETSAFA International Training Center Support
Solicitation number
N0018927RD001
Issued by

About this file

This is a Past Performance Report Form used by the U.S. Naval Supply System (NAVSUP) Fleet Logistics Center Norfolk (FLCN) to evaluate contractor performance on previous contracts relevant to solicitation N0018924XXXX. The form is completed by a third-party reference (government agency or customer) who has direct experience with the contractor's work and is submitted to the FLCN Contracting Department by the solicitation due date. The form explicitly instructs that completed questionnaires must not be returned to the contractor who originated the request, ensuring confidentiality of the reference feedback.

The questionnaire addresses four primary evaluation categories: Quality (recruiting ability, workforce retention, meeting contract requirements, customer satisfaction, rework/deficiency history, and innovative applications); Timeliness (schedule compliance and submission timeliness); Responsiveness (customer concern response, problem isolation and resolution, corrective action effectiveness, and cost control); and Additional Observations (contractor strengths/weaknesses, satisfaction with award decision, awareness of similar contracted efforts, and referrals to other potential references). The form requests detailed narrative responses on personnel qualifications and security clearances, workforce stability, product/service quality, schedule adherence, communication responsiveness, cost performance, and overall contractor suitability. Respondents provide command or company information, point of contact details, and may attach additional pages for expanded comments as needed.

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Text version

Solicitation N0018924XXXX

Source Selection Information – See FAR 2.101 and 3.104

PAST PERFORMANCE REPORT FORM

Complete and return NLT the due date of the solicitation to:

Fleet Logistics Center Norfolk (FLCN) Contracting Department Attn: First and Last Name, Code Phone:

Email:

On behalf of:

Company’s Name:

POC, Title/Position:

Email Address:

Contract/Purchase Order No.:

Contract Amount: $ Contract Type:

Period of Performance: Click or tap to enter a date. – Click or tap to enter a date.

Business Address:

Phone Number:

NOTE: DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS

REQUEST

The completion of this questionnaire is requested from your agency/company in order for the U.S. Naval Supply System (NAVSUP) Fleet Logistics Center Norfolk (FLCN) to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract resulting from the solicitation.

Completed by:

Command/Company’s Name:

POC, Title/Position:

Email Address Business Address:

Phone Number:

Quality:

1. Recruiting: The offeror’s demonstrated ability to recruit personnel with the skill sets, qualifications/certifications, experience and security clearance required of the contract.

Provide additional comments if necessary.

Click or tap here to enter text.

2. Retention: The offeror’s demonstrated ability to maintain a stable workforce.

Click or tap here to enter text.

3. Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.

a. How would you describe your level of customer satisfaction?

Click or tap here to enter text.

b. Were there instances of rework and/or deficiency reports? (If yes, explain)

Click or tap here to enter text.

c. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?

Click or tap here to enter text.

Timeliness:

1. Did the Contractor meet/comply with performance schedules?

Click or tap here to enter text.

a. Rate the timeliness of submission of requested information, reports and invoicing.

Click or tap here to enter text.

Responsiveness:

1. Describe the offeror’s demonstrated ability to respond to customer concerns

Click or tap here to enter text.

2. Describe the offeror’s efforts to isolate and resolve problems and take systematic improvement action. Please include:

� the number and severity of problems

� the effectiveness of corrective actions taken.

Click or tap here to enter text.

3. Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/under-run, Government-imposed schedule changes, etc.)

Additional Observations/Information:

1. Identify the contractor's overall strengths and weaknesses.

Click or tap here to enter text.

2. Given hindsight, are you satisfied that the contract was awarded to this contractor? Would you be pleased to have this contractor perform work for you again? Why?

Click or tap here to enter text.

3. Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

Click or tap here to enter text.

4. Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.

(If more comment space needed, please attach additional pages.)

File details come from the government source that posted it. Updated .