Enclosure_1_Past_Perf_Questionnaire.pdf

70Z02319RPPE05100

Enclosure 1

Past Performance Questionnaire (Complete one form per reference)

Please fill out the following information in regards to the solicitation.

SECTION A – TO BE COMPLETED BY OFFEROR

Offeror:

Contract Number:

BPA Number:

Order Number:

_____ Prime or _____ Subcontractor (Check one)

Dollar Amount: Date Completed:

Contract Type:

_____ Fixed Price _____ Cost Reimbursement _____ Other (Specify)

(Check one)

Item/Service Description:

Contract Quantity/Period of Performance:

Customer/Business/Agency Name:

Customer POC (Note: Ensure POC information is valid and current) Name:

Address:

Phone:

E-mail:

SECTION B – TO BE ADMINISTERED BY THE GOVERNMENT

The Offeror in Section A provided you as reference for a solicitation they are a party to. Please complete the following.

Evaluation

Indicate the contractor’s past performance for each category area and overall by identifying with an “x” of check mark for the most appropriate rating according to the scale shown below.

Provide rationale, including specific examples, as appropriate, to support your ratings in the space provided for comments for each category area. If more space is needed, continue your comments in the “Additional Comments” section at the end of this questionnaire.

Use the criteria for each category area in Table 1 in the assessment.

Use the rating definitions in Table 2 to assess contractor performance where appropriate.

TABLE 1- Category Area

Rating Description

Quality of Service Assessment based on the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

Schedule Assessment based on the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements

(e.g., efforts that contribute to or affect the schedule variance).

Cost Control Assessment based on the contractor’s effectiveness in forecasting, managing, and controlling contract cost.

***If contract is/was Firm-Fixed Price or Firm-Fixed Price with Economic Price

Adjustment, please mark “Not Applicable”***

Business Relations Assessment based on the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Management of Key

Personnel

Assessment based on the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

Utilization of Small

Business

Assessment based on whether the contractor provided maximum practicable opportunity for Small Business including Women Owned Small Businesses, Economically Disadvantaged Women Owned Small Businesses, HUBZone, Service

Disabled Veteran Owned Small Business, and 8(a) to participate in contract performance consistent with efficient performance of the contract. Also assessment based on compliance with all terms and conditions in the contract relating to Small

Business participation (including FAR 52.219-8, Utilization of Small Businesses and

FAR 52.219-9, Small Business Subcontracting Plan (when required).

***If Contractor is a Small Business Concern then mark Not Applicable”***

TABLE 2 - PERFORMANCE RATINGS DEFINITIONS

Rating Description

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

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

Unsatisfactory Performance does 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 appear or were ineffective.

Neutral No relevant performance record is identifiable upon which to base a meaningful performance rating. A search was unable to identify any relevant past performance information for the Offeror, key personnel, or subcontractors. In the case of an

Offeror without a record of relevant past performance or for whom information on past performance is not available, the Offeror may not be evaluated favorably or unfavorably on past performance.

Use the ratings in Table 3 to assess contractor performance where appropriate.

TABLE 3 - PERFORMANCE RATINGS

Category Rating

1. Quality of Service:

__Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__Neutral

2. Schedule: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

3. Cost Control:

__Satisfactory

__Marginal

__Unsatisfactory

__ Neutral

4. Business Relations: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__ Neutral

5. Management of Key Personnel: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__ Neutral

6. Utilization of Small Business:

__Satisfactory

__Marginal

__Unsatisfactory

Additional Comments:

Based on the categorical ratings use the Table 4 to assess contractor’s overall performance.

TABLE 4 – OVERALL PERFORMANCE RATING

Overall Rating

__Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory