Power_Amps_-_Attachment_(6)_-_Past_Performance_Questionnaire_-_ko_revied.docx
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- Solicitation number
- 70Z04419RN0007V000
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70Z04419RN0007V000 POWER AMPS - Attachment (6) - Past Performance Questionnaire
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DEPARTMENT OF HOMELAND SECURITY
U.S. COAST GUARD
COMMAND, CONTROL, AND COMMUNICATIONS ENGINEERING CENTER (C3CEN)
COMMAND, CONTROL, COMMUNICATIONS, COMPUTERS AND INFORMATION TECHNOLOGY SERVICE CENTER (C4IT-SC)
4000 COAST GUARD BOULEVARD
PORTSMOUTH, VA 23703
SOLICITATION: 70Z04419RN0007V000
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
In order to assess potential vendors, the C4IT-SC contracting office is obtaining past performance information with respect to each offeror. This PPQ must be completed by the Past Performance Reference, NOT the Offeror, and submitted directly to the Contracting Officer by the Past Performance Reference. The completed PPQ shall not be released to the offeror. In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. We are thanking you in advance for your time, effort, and cooperation in responding to this questionnaire. Please submit the completed form to “Toy” Benyetta Jefferson, Contract Specialist via email at Benyetta.Jefferson@uscg.mil and Stephen A. Clark, Contracting Officer via email at Stephen.A.Clark@uscg.mil. Please contact Ms. Jefferson at (757) 686-6874 if you have any questions. The completed PPQ is due on or before August 5, 2019 at 12:00 PM, EST.
I. GENERAL GUIDANCE
Please use the following rating in scoring the performance elements below (assessments should reflect only contractor-liable performance):
| RATING |
| DESCRIPTION |
| Exceeds |
| The Contractor's past performance far exceeds the customer's expectations and provided significant, unusual worthwhile features or benefits. |
| Satisfactory |
| The Contractor's past performance met the customer's expectations and contract requirements |
| Marginal |
| The Contractor's past performance could have been improved. The Contractor required major agency resources to ensure achievement of contract requirements. |
| Unsatisfactory |
| The Contractor's past performance did not meet customer expectations and/or contract requirements. |
II. GENERAL INFORMATION
A. AGENCY & RESPONDENT IDENTIFICATION:
| 1 |
| Name: |
| 2 |
| Title: |
| 3 |
| Organization: |
| 4 |
| Address: |
| 5 |
| Phone Number: |
| 6 |
| Fax Number: |
| 7 |
| E-mail Address: |
| 8 |
| Date: |
| 9 |
| Signature: |
B. CONTRACT IDENTIFICATION:
| 1 |
| Name of Contractor: |
| 1 |
| Type of Instrument |
(e.g. Contract/BPA/Order/Other):
| 2 |
| Contract Identification Number: |
| 3 |
| Order Number (If applicable): |
| 4 |
| Project Title and Service Description (Add rows if needed): |
| 5 |
| Type of Contract |
(e.g. Negotiated, Sealed Bid):
| 6 |
| Pricing Type (e.g. Fixed Price, T&M, |
Cost Reimbursement, other):
| 7 |
| Date of Award: |
| 8 |
| Contract Dollar Value/Ceiling: |
| 9 |
| Period of Performance: |
| 10 |
| Place(s) of Performance: |
C. GENERAL INFORMATION
| 1 |
| Has this Contractor ever failed to provide services required by the contract? If yes, explain. |
III. EVALUATION: How Would You Rate This Contractor With Respect To:
A. Compliance with the SOW and specifications; conformance to standards of good workmanship, and responsiveness to technical direction:
| Rating |
| Exceeds |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
Summary:
B. Adherence to the contract delivery schedule:
| Rating |
| Exceeds |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
Summary:
Summary:
C. Working relationship with Contracting Officer, COR, and other points of contact:
| Rating |
| Exceeds |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
Summary:
In summary, please give your overall assessment of this contractor.
Do you have additional comments to add?
70Z04419RN0007V000
Attachment 6
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