2.04 e Attachment V - Past Performance Report Form.pdf

PAST PERFORMANCE REPORT

FORM Solicitation N0018922Q0133

Complete and return BY EMAIL, NLT 114 July 2022 to:

Fleet Logistics Center Norfolk (FLCN)

Contracting Department, Attn: Heather Coleman, Code 240

Email: heather.l.coleman13.civ@navy.mil

On behalf of:

Company's Name: _________________________________

POC/Title/Position: _________________________________

Email Address: _________________________________

Contract/Purchase Order No.: _________________________________

Contract Amount: _________________________________

Contract Type: _________________________________

Period of Performance: _________________________________

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.

Completed by :

Command/Company’s Name: _________________________________

POC/Title/Position: _________________________________

Email Address: _________________________________

Address: _________________________________

Phone Number: _________________________________ joseph.d.singleton Highlight joseph.d.singleton Highlight

PAST PERFORMANCE QUALITY RATING TABLE

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.

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

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

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

b. Was the contractor able to consistently provide qualified personnel?

c. Were there instances of dismissal of contractor personnel due to poor performance or lack of professional endorsements?

4. Management.

a. Did the Contractor successfully manage schedules and requirements?

b. Was Contractor management responsive when issues/concerns were raised?

5. Additional Observations/Information

a. Identify any noteworthy strengths and/or weaknesses.

b. 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?

c. 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.

d. 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.)