Past_Perform_Attachment_II.docx

Attachment II 70Z04019Q64501B00 Oil and Coolant

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection

Please complete this Questionnaire and email to Dennis.S.Kokoskie@uscg.mil

Past Performance Assessment. The U.S. Coast Guard Surface Forces Logistics Center (SFLC) is soliciting competitive offers in order to place a Requirement Contract for testing of lube oil samples, coolant samples, storage of samples, data analysis and quality assurance of test results, related data management, and supply and shipping of sample bottle kits. SFLC is seeking proposals from potential

PLEASE RETURN THIS COMPLETED QUESTIONNAIRE TO Dennis S. Kokoskie@USCG.MIL Phone (410) 762-6747 Desired Response Date: July 24, 2019

If you need more space than that provided, please attach additional pages. Responses will be treated as source selection sensitive information (41 U.S.C. 423) and shall be protected accordingly. If you have any questions, please contact the Contract Specialist at the above e-mail address.

1. Contract Information. Please complete the following:

Contractor Name & Address:

Contract Number:

Period of Performance:

Dollar Amount at Award:

Dollar Amount at Completion (or Current Dollar Amount, if not Completed):

Contract Type: Fixed-Price; Labor Hour or Time and Material; Cost-Reimbursement (CPFF, CPAF, CPIF, etc.)

Describe the Products or Services:

Performance Assessment Values.

5 - Exceptional. Performance meets contractual requirements and exceeds many requirements, to the Government’s (Your Company) benefit. Contractual performance of the element being assessed was accomplished with no problems for which corrective actions taken by the contractor were highly effective.

4 – Very Good. Performance meets contractual requirements and exceeds some requirements, to the Government’s (Your Company) benefit. Contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 – Satisfactory. Performance meets contractual requirements. Contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

2 - Marginal. Performance does not meet some contractual requirements. Contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

1 - Unsatisfactory. Performance does not meet most contractual requirements and recovery is not likely in a timely manner. Contractual performance of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

0 - Not Applicable. Unable to provide a score. Performance in this area not applicable to effort assessed.

1. Assessment Elements. Please select/circle/underline the appropriate performance assessment value for each item on the questionnaire and provide supporting narrative.

a. Cost Control. Rate the contractor’s effectiveness in forecasting, managing, and controlling cost (including reporting and analyzing variances) and ability to deliver at the agreed-to cost/price. Provide reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes).

5 4 3 2 1 0

Comments:

b. Schedule. Rate the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

5 4 3 2 1 0

Comments:

c. Mission Requirements. Rate the contractor’s ability to provide a product or service that met your mission requirements.

5 4 3 2 1 0

Comments:

d. Quality. Rate the contractor’s ability to provide a product or service that met your required level of quality. Assess 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.)

5 4 3 2 1 0

Comments:

e. Socioeconomic Goals. Rate the contractor’s ability to meet any applicable subcontracting goals for utilization of Small Business (SB), Small Disadvantaged Businesses (SDB), Women-Owned Small Businesses (WOSB), Service-Disabled Veteran-Owned Small Business (SDVOSB), HUBZone and Historically Black Colleges and Universities/Minority Institutions (HBCU/MI).

5 4 3 2 1 0

f. Subcontractor (Partners) Management. Rate the contractor’s ability to timely award and manage subcontracts.

5 4 3 2 1 0

Comments:

g. Business Relations. Rate the contractor’s ability to integrate and coordinate all activities needed to execute the contract, specifically the timeliness, completeness, quality of problem resolution, corrective action plans, the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and its ability to submit accurate invoices in a timely manner.

5 4 3 2 1 0

Comments:

h. Management of Key Personnel. Assess the contractor’s performance in selecting, retaining, supporting, and replacing—when necessary—key personnel.

5 4 3 2 1 0

Comments:

i. Recommendation. To what extent would you recommend this contractor for additional contracts? Rate on the following scale: 5 = Yes, definitely; 4 = Yes, likely; 3 = Maybe, 2 = No, not likely; 1 = No, not ever; 0 = N/A.

5 4 3 2 1 0

Comments:

Name, Phone, and E-Mail Address:

Assessor Information. Please provide the following information about yourself:

Name:

Title:

Address:

Phone Number:

E-Mail Address:

Thank you for your assistance.

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 6