Att_6__Final_Past_Performance_Questionnaire.docx

68HE0H18FR0030

Conflict Prevention and Resolution Services

Attachment 6

PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACTOR & PROJECT IDENTIFICATION

This section to be completed by the Offeror.

Company Name:

Reference Contract No.:

Reference Title:

Period of Performance:

Type of Competition (Select all that apply):

|_| Competitive |_| Sole Source (including direct 8(a) or ANC award) |_| Full and Open (no restrictions) |_| Set-aside for small business concerns

Type of Contract/Award (Select all that apply):

|_| IDIQ

|_| BPA

|_| Firm Fixed Price |_| Time-and-Material |_| Cost-reimbursement

Total Value of Awarded Contract:

Total Value of Relevant Work:

Brief Description of Work Relevant to CPRS SOW: (insert description in text box below)

II. EVALUATOR INFORMATION

This section to be completed by the individual responsible for evaluating the Offeror’s performance under the referenced contract.

Please provide the following information to assist EPA in tracking responses. This information is confidential and will not, under any circumstances, be divulged to other than the Contracting Officer and the Technical Evaluation Panel.

Evaluator’s Name:

Email Address:

Office Phone:

Current Title:

Agency / Organization:

Role in Referenced Contract:

If NO, please explain:

III. GENERAL INFORMATION

This section to be completed by the individual responsible for evaluating the Offeror’s performance under the referenced contract.

If YES, please explain:

Has the contract been partially or completely terminated?

YES |_| NO |_|

If YES, was it termination for Default/Cause or Convenience?

Default / Cause |_| Convenience |_|

Please provide reason for termination:

Was there any deduction in monthly invoice(s)?

YES |_| NO |_|

If YES, please explain:

Changes in the contract dollar value throughout the life of the contract are/were attributable, for the most part, to:

|_| Customer-issued changes |_| Contractor submitted claims/requests for equitable adjustment |_| Other |_| Not applicable; no change to the contract dollar value

|_| Time-and-Material |_| Cost-reimbursement

Please explain:

IV. PAST PERFORMANCE INFORMATION

This section to be completed by the individual responsible for evaluating the Offeror’s performance under the referenced contract. Insert an “X” in the appropriate box indicating the assigned rating for each element evaluated.

Please use the following adjectival descriptions for rating the Contractor's performance in Staffing, Management, and Technical:

1. STAFFING PERFORMANCE

Contractor's demonstrated ability to provide qualified staffing resources for the support services

Contractor's ability to satisfy security requirements and to obtain clearances for staffing resources in a prompt fashion

Personnel arriving on the job with all of the requisite skills to perform the work

Key Personnel performed in the proposed roles on prior projects

Key Personnel experience in project management processes, procedures, use of automated tools, and industry best practices for providing and managing conflict prevention and resolution services

Contractor ability to provide qualified subject matter experts when required

Capability of personnel to respond to changing priorities

Key Personnel turnover

Contractor and subcontractor personnel qualifications and experience levels in relation to their assigned tasks

Contractor's flexibility and ability to quickly address varying levels of effort and staffing requirements across multiple concurrent requirements

OVERALL STAFFING RATING

Please explain any ratings assigned other than Satisfactory or Not Applicable:

2. MANAGEMENT PERFORMANCE

Contractor's performance in planning, scheduling, controlling, monitoring and reporting on deliverables

Effectiveness of Contractor's organizational structure, span of control and escalation procedures in providing successful performance

Contractor's ability to manage and coordinate among multiple and changing priorities while continuing to meet schedule and resource constraints

Responses to questions/technical/ service/administrative issues

Relationships with other prime contractors

Management of teaming partners and/or subcontractors and their responsibilities, including clearly identified duties, assignments, and directions

Contractor's adherence to sound management practices to control activities and accurately report on status when COR/COTR requests

Contractor use of innovative, best practice methodologies and creativity for problem solving

OVERALL MANAGEMENT RATING

Please explain any ratings assigned other than Satisfactory or Not Applicable:

3. TECHNICAL PERFORMANCE

Quality of deliverables and work products

Demonstrated performance in meeting customer and/or contractual requirements

Effectiveness of case tracking system in providing up-to-date financial data; comprehensive reporting of status, progress, and all case data at the contract, task order and technical directive levels; and maintaining current document repository.

Experience design and delivery of situation assessment, stakeholder assessment, conflict assessment, or convening process

Experience design and delivery of alternate dispute resolution for agreement seeking processes for National Policy and Regulatory Issues

Experience design and delivery of alternate dispute resolution for agreement seeking processes for Site, Facility or Geographic Area Negotiations

Experience design and delivery of consultation and information exchange for National Policy and Regulatory Issues

Experience design and delivery of consultation and information exchange for Site, Facility or Geographic Area Negotiations

Experience design and delivery of just-in-time (i.e. quick response) dispute prevention and resolution

Experience design and delivery of workplace dispute prevention and resolution

Experience design and delivery of strategic planning, organizational development and career development coaching support

Experience design and delivery of arbitration services and support

Experience design and delivery of training services and support

Experience and delivery of meeting logistical support

Experience and delivery of expert technical and scientific assistance

Experience design and delivery of communications, information exchanges and education processes such as document repositories, help lines, teleconference calls, video conference calls and electronic communications through web sites, list serves, on-line dialogues, podcasts, social media, or text messages

Demonstrated ability to gather, compile, categorize, report, research, analyze, and prepare responses to public comments

Experience, design and delivery of evaluation of conflict prevention and resolution services.

Demonstrated ability to research, design, write and edit fact sheets, brochures, white papers, analyses, data presentations, meeting presentations, webcasts, videos, online postings, social media messages, webpages, and other documents, presentations or papers required to educate parties in a potential or actual dispute or issue in controversy regarding the programmatic, scientific or technical information, policy or factual matters

OVERALL TECHNICAL RATING

Please explain any ratings assigned other than Satisfactory or Not Applicable:

4. FIDUCIARY (COST CONTROL) PERFORMANCE

Contractor uses and communicates cost-effective alternatives

Accuracy of contractor estimates and ability to remain within funding limits and/or contract value

Contractor's ability to control costs while still meeting deadlines and providing quality personnel and deliverables

Contractor’s ability to provide accurate and timely invoices detailing hours, rates and costs

OVERALL FIDUCIARY RATING

Please explain any ratings assigned other than Satisfactory or Not Applicable:

VI. OVERALL EVALUATION:

This section to be completed by the individual responsible for evaluating the Offeror’s performance under the referenced contract. Insert an “X” in the appropriate box indicating the assigned rating for each element evaluated.

Please explain any ratings assigned other than Satisfactory:

If NO, please explain:

Additional Comments:

SOURCE SELECTION SENSITIVE INFORMATION

See FAR 2.101, 3.104, and 42.1503

SOURCE SELECTION SENSITIVE INFORMATION

See FAR 2.101, 3.104, and 42.1503