36C24518R0046-030.pdf

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104

Multiple Award Task Order Contract (MATOC) II

36C24518R0046

ATTACHMENT - 7

PAST PERFORMANCE QUESTIONNAIRE

1. TRANSMITTAL LETTER SAMPLE

<Your Company Letterhead>

Date: ___________________

To:

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by Network Contracting Office 5 (NCO 5), located at

Boiler House Road, Bldg 101 Rm 9, Perry Point, MD 21902.

In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance, and your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible.

Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306

(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to the following address. Do not return them to the contractor.

Department of Veterans Affairs

Network Contracting Office 5 (NCO 5)

Attn: Marvin Nunez or via email to: Marvin.nunez@va.gov

Boiler House Road, Building 101 Rm 9

Perry Point, MD 21902

If you have questions regarding the attached questionnaire, or require assistance, please contact Mr.

Marvin Nunez via email provided above.

Thank you for your assistance.

Please be advised that “E-Mail” is the preferred method of receiving the requested information.

<Signature and Title of Principal> mailto:Marvin.nunez@va.gov

Multiple Award Task Order Contract (MATOC) II

2. GENERAL INFORMATION: (Contractor to be evaluated)

Name of Contractor:

Point of Contact: Title: E-mail:

Address of Record: Office Phone: Fax:

Contract#: Award Dollar Amount:

Dates of Performance:

Number of Modifications: _______________

Final Contract Dollar Amount:______________

Contractor Performed as: Prime Contractor Sub-Contractor Key Personnel

Project Title and Brief Description of Work:

*Note: If offeror holds or has held other contracts with your agency/organization in the last 4 years, please complete separate evaluation forms for those contracts as well.

3. RESPONDENT INFORMATION: (Government Official)

Name of Respondent: Title: E-mail:

Address of Record: Office Phone: Fax:

4. TRANSMITTAL INSTRUCTIONS: E-mail completed survey to Marvin Nunez, Network

Contracting Office 5 (NCO 5) at marvin.nunez@va.gov.

mailto:bryan.burgee@va.gov

Multiple Award Task Order Contract (MATOC) II

5. PERFORMANCE INFORMATION: Choose the appropriate adjectival rating that most accurately describes the contractor’s performance.

Exceptional Performance exceeded many contractual requirements to the government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an

Exceptional rating. Also, there should have been NO significant weaknesses identified.

Very Good Performance exceeded some contractual requirements to the government’s benefit. The contractual performance of the element or sub-element being assess was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were effective.

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the

Government/Owner. There should have been no significant weaknesses identified.

Satisfactory Performance met contractual requirements. The contractual performance of the element or sub-element being assess was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

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

A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner.

Unsatisfactory Performance did 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 were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the

Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

Neutral/ Not

Applicable or

Unknown

No performance record identifiable within the area of evaluation.

Performance was not observed or not applicable to the current effort being reported.

TO BE COMPLETED BY CLIENT

Multiple Award Task Order Contract (MATOC) II

36C24518R0046

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

Quality of technical data/report preparation efforts E VG S M U N

Ability to meet quality standards specified for technical performance

E VG S M U N

Timeliness/effectiveness of contract problem resolution without extensive customer guidance

E VG S M U N

Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements

(without adverse effect on performance)

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

Compliance with contract delivery/completion schedules including any significant intermediate milestones

E VG S M U N

Rate the contractor’s use of available resources to accomplish tasks identified in the contract

E VG S M U N

Quality and completeness of contractor schedule E VG S M U N

3. CUSTOMER SATISFACTION:

To what extent were the end users satisfied with the project? E VG S M U N

Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication)

E VG S M U N

To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer?

E VG S M U N

Overall customer satisfaction E VG S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

E VG S M U N

Ability to hire, apply, and retain a qualified workforce to this effort

E VG S M U N

Government Property Control E VG S M U N

Knowledge/expertise demonstrated by contractor personnel

E VG S M U N

Ability to simultaneously manage multiple projects with multiple disciplines

E VG S M U N

Multiple Award Task Order Contract (MATOC) II

Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E VG S M U N

Effectiveness of overall management (including ability to effectively lead, manage and control the program)

E VG S M U N

5. COST/FINANCIAL MANAGEMENT

Ability to meet the terms and conditions within the contractually agreed price(s)?

E VG S M U N

Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E VG S M U N

Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes No

If this is/was a Government contract, has/was this contract partially or completely terminated for default or convenience or are there any pending or current cure/show cause notices.

Yes

No

6. SAFETY/SECURITY

To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E VG S M U N

Contractor complied with all security requirements for the project and personnel security requirements.

E VG S M U N

7. GENERAL

Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting

Officer in a timely manner regarding urgent contractual issues).

E VG S M U N

Compliance with contractual terms/provisions (explain if specific issues)

E VG S M U N

Would you hire or work with this firm again? (If no, please explain)

Yes No

In summary, provide an overall rating for the work performed by this contractor.

E VG S M U N

Please provide frank responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (attach additional pages if necessary):