1305M324R0061_A2_Performance_Form_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Instructions to Offerors Sending Reference Questionnaire Forms:

Section A shall be completed by the Offeror (the firm requesting the reference) prior to issuing the questionnaires. The Offeror shall send the questionnaires for relevant projects that are in progress or completed in the past three (3) years to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer’s Representative. For commercial references, send to personnel with duties similar to those for Government contracts. It is the responsibility of the Offeror to follow-up and encourage references to submit the questionnaire. The completed questionnaire shall be submitted via e-mail directly from the person providing the reference.

Instructions to Person Providing Reference:

In order to assess potential vendors under the Department of Commerce (DOC), the National Oceanic and Atmospheric Administration (NOAA), Acquisition and Grants Office (AGO), Western Acquisition Division (WAD) is obtaining past performance information with respect to each Offeror. As a reference for work performed by the firm identified in Section A of this questionnaire, your candid response will assist in the evaluation process. Please complete Section B of the questionnaire as thoroughly as possible. The questionnaire must be submitted to Anna.Ma@noaa.gov no later than 2:00 PM (Pacific Time), June 5, 2024. The subject line in the submission e-mail shall clearly indicate: Solicitation 1305M324R0061 – Heating Oil for James J. Howard Laboratory. Past Performance Questionnaire. The body of the email should include the submission for <Company Name> and the message shall originate from the reference’s government or commercial e-mail system.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. If you have questions regarding this questionnaire or require assistance, please submit inquiries to Anna.Ma@noaa.gov.

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: OFFEROR INFORMATION

Company Name and Division Name of Offeror:

Offeror Address:

Offeror DUNS/UNIQUE ID:

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART II: PAST PERFORMANCE INFORMATION

Title of Project / Contract Number for which Reference Requested:

Procurement Vehicle (e.g. Contract / Order/ Subcontract / Other):

Type of Contract (e.g. Negotiated, Sealed Bid):

Pricing Type (check all that apply)

FP FPI CPFF CPAF CPIF IDIQ BOA

Requirements Labor-Hour T&M Other (specify)______________________

Date of Award:

Period of Performance (Including Options):

Contract Amount:

Initial Contract Dollar Value (w/Options):

Final Contract Dollar Value (w/Options):

Role One Project:

Prime Subcontractor (explain type and extent of role): _________________________________________________

General Description of Type of Services / Products Required Under the Contract:

Describe Complexity of Work:

PART I: REFERENCE INFORMATION

Name and Title:

Organization (including Agency and / or Company):

Contract Role (e.g. CO, COR, PM):

Address:

Phone Number:

Fax Number:

E-Mail:

PART II: INFORMATION ABOUT PROJECT / CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A:

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A: Unknown risk would be the equivalent to the evaluator providing a “Not Applicable (N/A)” to any of the questions.

*Failure of customers to provide an explanation to "exceptional," "marginal," or "unsatisfactory" ratings may result in a lower rating.

Quality of Product or Service

E VG S M U N/A

1. Contractor’s ability to meet minimum requirements specified for performance.

2. Contractor’s compliance with contractual terms and conditions.

3. Contractor’s ability to meet specific response times and scheduled timeframes for completion of specific tasks.

4. Overall rating of contactor’s quality of service.

Comments:

Business Relations

E VG S M U N/A

1. Contractor’s ability to correct problems and prevent or mitigate potential problems in a timely manner.

2. Contractor’s ability to use effective approaches and provide technical expertise and resources to solve contract problems.

3. Extent to which the contractor has demonstrated reasonable and cooperative behavior.

4. Contractor’s effectiveness to interfacing with all customers.

5. Overall rating of customer satisfaction.

Comments:

Management of Key Personnel

E VG S M U N/A

1. Contractor’s ability to meet appropriate staffing levels with qualified personnel in order to provide required services.

2. Rate the contractor’s ability to replace key personnel in a timely fashion.

3. Rate the level of the functional expertise of the contractor’s staff.

4. Overall rating of contactor’s management of key personnel.

Comments:

Compliance with Labor, Environmental Safety, Health and Security Requirements

E VG S M U N/A

1. Contractor’s compliance with safety requirements.

2. Contractor’s ability to accommodate health requirements.

Comments:

Cost Management

E VG S M U N/A

1. Extent to which the contractor provided reliable, supportable cost estimates/proposals.

Comments:

Contractual Considerations

YES NO

1. Has an election ever been made not to exercise an option or continue relations due to contractor’s poor performance? If YES, please comment below.

2. Has a Contract Discrepancy Report ever been issued? If YES, please comment below.

3. Has this contract been partially or completely terminated for default or convenience?

Partially Completely If YES, please comment below.

4. Would you contract with or hire this contractor again? If NO, please comment below.

E VG S M U N/A

5. Overall rating of contactor’s performance under this contract.

Comments:

Signature Date