1625DC-17-Q-00021_Attachments_1-3.pdf

1625DC-17-Q-00021 Attachment

Source Selection Information – See FAR 2.101 and 3.104

ATTACHMENT 1

PAST PERFORMANCE INFORMATION SHEET (PPIS)

PAST PERFORMANCE INFORMATION SHEET (PPIS)

Provide the information requested in this form for each Past Performance Reference as required by

1.4.4. Provide frank, concise comments regarding performance on the reference you identify. Provide a separate completed form for each reference submitted. Submit the forms as part of the Past Performance Volume.

A. Offeror Name (Company/Division):

*Please identify if you are a teaming member or subcontractor with the prime

Cage Code:

DUNS Number:

(NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes below. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume).

B. Program Title:

C. Contract Specifics:

1. Contracting Agency or Customer:

2. Citation Number:

3. Contract Type:

4. Period of Performance:

5. Original Contract $ Value (Do not include unexercised options):

6. Current Contract $ Value (Do not include unexercised options):

7. If the amounts for 5 and 6 above are different, provide a brief description of the reason below.

8. Original completion date:

9. Current scheduled completion date:

10. Estimated completion date:

11. Number of contract changes:

12. Enter primary cause for contract changes below:

D. Enter below a brief description of effort as Prime or Subcontractor.

E. Primary customer points of contact. (For Government contracts/orders, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

1. Program Manager and/or Site Manager

2. Procurement Contracting Officer

3. Administrative Contracting Officer

Name

Office

Address

Telephone

FAX #

E-Mail

F. Address below any technical (or other) area about this citation considered unique.

G. Describe the relevancy to the Technical Capability, Factor 1, Subfactor 1 for which this citation applies. Illustrate how your experience on this program applies to that subfactor.

H. Subcontracting Plan Requirements.

1. Was a subcontracting plan required? _______ If YES, go to # 2. If NO, skip this section.

2. Planned goal (%) Achieved goal (%)

3. Explain below why goals were not met.

ATTACHMENT 2

CONSENT FORM

CONSENT FORM

FOR THE RELEASE OF PAST PERFORMANCE INFORMATION

TO THE PRIME CONTRACTOR

Past performance information concerning teaming partners cannot be disclosed to a private party without the teaming partner's consent. Because a prime contractor is a private party, the Government will need that consent before disclosing subcontractor past performance information to the prime during exchanges. In an effort to assist the Government's Performance Confidence Assessment Group (PCAG) in assessing your past performance relevancy and confidence, we request that the following consent form be completed by the major teaming partners identified in your proposal. The completed consent forms should be submitted as part of your Past Performance Volume.

SAMPLE

Dear (Contracting Officer)

We are currently participating as a (teaming partners) with (prime contractor or name of entity providing proposal) in responding to the Bureau of Labor Statistics, (location) request for Proposal (solicitation number) for the (program title or description of effort).

We understand that the Government is placing increased emphasis on past performance in order to obtain best value in source selections. In order to facilitate the performance confidence assessment process we are signing this consent form to allow you to discuss our past performance information with the prime contractor during the source selection process.

(Signature and Title of individual who has the authority to sign for and legally bind the company)

Company Name:

Address:

*Please identify if you are a teaming member or subcontractor with the prime

ATTACHMENT 3

Mail-in Past Performance Questionnaire

TO: Government agency or commercial organization (i.e., customer) with knowledge of the Offeror's past performance.

Please complete this questionnaire, which concerns the past performance of a contractor or subcontractor who is doing business (or has done business) with you, and is interested in doing business with the U.S. Department of Labor (DOL). Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages. Responses will be treated as source selection sensitive information. The contractor who provided DOL with your name as a reference was informed, via a solicitation provision, that by listing you as a reference and requesting your submission of the questionnaire, they are authorizing you to release information to DOL relative to their past performance, whether it is positive or negative information.

Email the completed questionnaire to the attention of the responsible Contracting Officer. The Offeror must fill in the solicitation number, fax number, email address, and name of Contracting Officer below, prior to providing you with the questionnaire, or provide you with the information to fill in. Your completed questionnaire must be provided directly to the Contracting Officer from you. DOL will not accept completed questionnaires sent from the Offeror.

(Attachment 3) PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN, THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION

IAW FAR 2.101 AND 3.104

Offeror: Complete SECTION 1, then e-mail questionnaire to the customer points of contact listed on the Past Performance Information Sheet for the contract identified.

Offeror’s Evaluator: Complete SECTIONS 2-3 and e-mail to: liu.jason@bls.gov and jones.elliott@bls.gov

(DO NOT PROVIDE COPY BACK TO THE OFFEROR)

SECTION 1: CONTRACTOR IDENTIFICATION

A. Contractor *Please identify if you are a teaming member or subcontractor with the prime

B. Prime Contractor Cage Code

C. Contract Number

D. Contract Type

E. Was this a competitive contract? Yes No

F. Period of Performance

G. Initial Contract Cost ($)

H. Current/Final Contract Cost ($)

I. Reasons for differences between initial contract cost and final contract costs (enter below):

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or Agency Name

B. Customer or Agency Description (if applicable)

C. Geographic description of services under this contract, i.e., local, nationwide, worldwide, other Command

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's Name

B. Evaluator's Title

C. Evaluator's Phone/Fax Number

D. Number of years evaluator worked on subject contract mailto:dell.kristin@bls.gov mailto:chaney.lasondia@bls.gov

DOL-BLS-16-Q-00027 Attachments

SECTION 4: NARRATIVE SUMMARY

What were the contractor’s greatest strengths in the performance of the contract?

What were the contractor’s greatest weaknesses in the performance of the contract?

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

(Attachment 3) PAST PERFORMANCE QUESTIONNAIRE