1625DC-18-Q-00016_Attachments_1-3.pdf

1625DC-18-Q-00016 Attachment 1

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.

Source Selection Information – See FAR 2.101 and 3.104

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 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.

1625DC-18-Q-00016 Attachment 2

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 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 response. 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 the response) in responding to the Bureau of Labor Statistics, (location) solicitation (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

1625DC-18-Q-00016 Attachment 3

ATTACHMENT 3

Email-in Past Performance Questionnaire

(Attachment 3) PAST PERFORMANCE QUESTIONNAIRE WHEN FILLED IN, THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 AND 3.104

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.

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: deangelis.michael@bls.gov and liu.jason@bls.gov.

(DO NOT PROVIDE COPY BACK TO THE OFFEROR)

SECTION I: (To be filled out by the Offeror)

Contract Name/Program Name

Contract/BPA/Task Order Number(s)

Type of Contract

Contract Period of Performance

Contract Duration

Contract/Task Order Amounts

Name/Contact Information of Customer Point of Contact for Offeror Information (Telephone, Fax, Email Address, Mail Address)

Other Relevant Information (Please specify if previous Deaf consumer)

SECTION II: (To be filled out by the client reference completing the questionnaire) The information provided in this section by the client references shall be of past performance that is relevant for contracts and/or sub-contracts in any amount and shall be on project work same or similar in nature as that provided in the performance work statement.

Name of Company/Federal, State, or Local Agency completing the Questionnaire

Name of person completing the Questionnaire

Agency/Company/Organization

Your role with respect to the Contractor (e.g. Contracting Officer, Program Manager, Consumer, etc.)

Length in role (years and months)

Email Address

Telephone Number (include area code)

Fax Number (include area code)

Other Relevant Information

Information Accuracy:

Is the information provided by the Offeror in Section I accurate, to the best of your knowledge?

[ ] YES [ ] NO

SECTION III: (To be filled out by the client reference completing the questionnaire) The information provided in this section by the client references shall be of past performance that is relevant for contracts and/or sub-contracts in any amount and shall be on project work same or similar in nature as that provided in the performance work statement.

Please use the following rating scale to rate the Contractor:

RATING EXPLANATION

Exceptional Surpasses the minimum performance level of the contract.

Satisfactory Meets the performance level of the contract.

Marginal Often does not meet the performance level of the contract.

Unsatisfactory Does not meet the performance level of the contract.

Not applicable Not applicable to the contract.

For each segment, please include narrative with specific, relevant examples where at all possible. Additional comments may be attached, as necessary.

A. Prime Contractor’s Management Practices

1. Please rate the Contractor’s Management structure in terms of responsiveness, efficiency and how well it met the needs of your company or agency.

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

2. How effective and thorough was the Contractor in reporting on the Contractor’s performance?

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

3. How effective and professional was the Contractor in working and communicating with agency or customer personnel?

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

Comments:

B. Prime Contractor’s Performance

1. How valuable and instrumental were the Contractor’s performance reports to your agency’s goals and objectives and planning activities?

2. How well was the Contract staffed to be able to fill requests appropriately?

3. What was the level of skill and competency of the interpreters provided by the Contractor?

Comments:

C. Prime Contractor’s Delivery Schedules

1. Please rate the Contractor’s ability to confirm receipt of requests in a timely manner.

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

2. Please rate the Contractor’s ability to deliver the requested services on time and at the agreed upon rate.

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

D. Summary

1. Were there any instances in which the Contractor received additional consideration for superior performance?

[ ] YES [ ] NO [ ] NOT APPLICABLE

2. Were there any instances in which the Contractor was required to provide explanations due to poor performance or the non-availability of the system/services/staff resources?

[ ] YES [ ] NO [ ] NOT APPLICABLE

Please rate the overall performance of the Contractor:

RATING Please check one.

Exceptional

Satisfactory

Marginal

Unsatisfactory

Not applicable

E. Additional Comments

Please provide any additional comments regarding this Contractor’s past performance, as desired, either below or as an attachment:

*By signing this Questionnaire, I verify that the information contained in this reference is accurate, to the best of my knowledge.*

PRINTED NAME

TITLE

AGENCY/ORGANIZATION/ROLE

Signature

ATTACHMENT 3