2.04.19 Attachment (18) - Past Performance Questionnaire.pdf

Source Selection Plan

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 For Official Use Only

Attachment (3)

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY THE RESPONDENT AND RETURNED TO FLC PH

(PLEASE DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS

REQUEST)

A. The completion of this questionnaire is requested from your agency/company to assist with establishing the performance history for the Contractor named below. This questionnaire will be utilized by NAVSUP Fleet Logistic Center Pearl Harbor to evaluate the aforementioned contractor’s past performance on previous contracts as it relates to the probability of successful accomplishment of the work required by the Government relative to the award of the contract resulting from the solicitation.

Please provide concise comments regarding your overall assessment of the contractor’s performance on the contract identified below. Please respond to each question in a narrative format. In efforts to expedite receipt of the requested information, the Contracting Office respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to: kyle.p.quintal.civ@us.navy.mil, or fax to 808-473-3524.

Solicitation Data (for the proposed effort)

Solicitation Number:

Requirement: Packing, Containerization and Local Drayage of Direct Procurement

Method (DPM) Personal Property Shipments Customer/Agency: NAVSUP FLEET LOGISTCIS CENTER (FLC) PEARL HARBOR

(PH) JOINT PERSONAL PROPERTY SHIPPING OFFICE (JPPSO)

Requirement Description: The objective of this acquisition is to procure packing, containerization and local drayage services via contractor services to furnish all personnel, equipment, facilities, supplies, services and materials for the preparation of personal property of Department of Defense (DoD) personnel for shipment and/or storage and related services

Company's Name:

POC/Title/Position/Role:

POC/Title/Position/ Role:

Contract/Purchase Order No.

Contract Value:

Contract Type:

Period of Performance:

Business Address:

Phone Number:

Email Address:

Please select from the following as it applies to this contract:

Contracting Role PRIME SUBCONTRACTOR Termination History Convenience Default N/A

N0060425R4003

For Official Use Only

Attachment (3)

The following definitions should be used in your assessment of Contractor performance.

B. Explanation of codes:

Performance Ratings Code Rating Definition G GOOD Superior accomplishment of contract requirements and very high customer satisfaction.

A ACCEPTABLE Fully compliant accomplishment of contract requirements and positive customer satisfaction.

M MARGINAL Accomplishes most, but not all, of the desired contract requirements and customer is marginally satisfied.

UA UNACCEPTABLE Failure to properly accomplish contract requirements and failure to satisfy customer.

N NEUTRAL Unable to provide a score. Performance in this area not applicable to effort assessed.

C. Check the appropriate code for each item on the questionnaire and provide supporting narrative. At a minimum, rationale must be provided for ratings of unsatisfactory.

1. Rate the Offeror’s Quality of Performance:

(i) Overall satisfaction with the Offeror:

G A M UA N

Please provide rationale for the assigned rating.

b. Assess the Contractor’s quality of performance in the following areas.

G A M U N Conformance to Contract Requirements Conformance to Specifications Standards of Good Workmanship (technical, professional, environmental, safety, etc.)

For Official Use Only

Attachment (3)

(iii) Instances of rework and/or deficiency reports:

G A M UA N

(iv) Effective and/or innovative work applications that were beneficial to you:

2. Rate the Offeror’s Schedule Performance:

(i) Timeliness in completion of delivery and/or performance schedules. What were the causes of any delay?

(ii) Timeliness in submitting deliverables such as requested information, reports, and invoicing:

3. Rate the Offeror’s Responsiveness:

(i) Demonstrated ability to respond to your concerns, isolate and resolve problems and take systemic improvement action:

(ii) Did the product meet the required level of quality?

(iii) What is your overall rating of the contractor’s performance (technical, schedule, management, and cost)?

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

E. Given the choice, would you award to this contractor again?

F. 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.

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

Assessor’s Signature Date