Exhibit 13 Rev 1 - OMESIII PastPerfQues.pdf

RFP 80GSFC21R0046

EXHIBIT 13

OMES III

REVISION 1,

PAST PERFORMANCE

QUESTIONNAIRE

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

(Updated May, 2018)

Sections 1-3 provide for contract-related descriptive information and identification of the evaluator.

Section 4 lists the major work elements within our Statement of Work (SOW). Please provide your assessment of the “relevant experience” and “performance” associated with our SOW evidenced within the contract for which you are a reference. “Experience” means a contractor who has performed work in the specific SOW Element. “Did not Perform” means that the specific SOW element was not performed under the contract.

S ection 5 evaluates the contractor’s technical, schedule, and cost performance and management. (Additional pages may be used for comments if desired). If you cannot answer any questions, please circle “N/R” for Not Rated.

The following definitions are offered for your use in assigning a performance rating for each of the factors in Sections 5 and 6:

Very High

(VH)

The Offeror’s relevant past performance is of exceptional merit;

indicating exemplary performance in a timely, efficient, and economical manner; very minor (if any) problems with no adverse effect on overall performance.

High

(H)

The Offeror’s relevant past performance demonstrates very effective performance that would be fully responsive to contract requirements with contract requirements accomplished in a timely, efficient, and economical manner for the most part with only minor problems with little identifiable effect on overall performance.

Moderate

(M)

The Offeror’s relevant past performance demonstrates effective performance; fully responsive to contract requirements; reportable problems, but with little identifiable effect on overall performance.

Low

(L)

The Offeror’s relevant past performance meets or slightly exceeds minimum acceptable standards; adequate results; reportable problems with identifiable, but not substantial, effects on overall performance.

Very Low

(VL)

The Offeror’s relevant past performance does not meet minimum acceptable standards in one or more areas; remedial action required in one or more areas; problems in one or more areas which, adversely affect overall performance.

N/R Not Rated

Section 6 provides for evaluation of the contractor’s management of cost and award/incentive fee history.

RETURN THIS QUESTIONNAIRE TO NASA Goddard Space Flight Center BY JUNE 7, 2022. Attn: Tasha Williams, Code 210.M

Greenbelt, MD 20771 Phone: 301-286-3459 e-mail: tasha.williams@nasa.gov mailto:tasha.williams@nasa.gov

PAST PERFORMANCE QUESTIONNAIRE

1. C ontract Information

A. Name of Company/Division Being Evaluated:

B. Address:_ _

C. Contractor Cage Code and/or DUNS number

D. Contract Number: _

E. Contract Type: _

F. Period of Performance (including options): From: To: _

G. Total Contract Value:_ _

H. Award Information: Competitive: Yes_ No_ Basis of Selection: Technical _ Cost/Price _ Other (specify)

2. Description of Contract

Briefly describe the services provided under this contract:

During the contract performance being evaluated, this firm was the:

Prime Contractor Significant Subcontractor _ Team Member _ Other (describe)_ _

Does a corporate or business relationship exist between the firm being evaluated and your organization?

Yes _ No _ . If yes, please describe:

3. E valuator Information

Name: _ Title: _ Agency/Company: _ _ E-mail Address:

Phone: Date Questionnaire Completed:

Role in Program/Contract: _ _ Length of Involvement in this Program/ Contract: _

P AST PERFORMANCE QUESTIONNAIRE

4. SOW Survey Relevance Ratings: Please check the appropriate blocks for Relevance (Performed or Did Not Perform)

SOW ELEMENT

SIGNIFICANT

MODERATE

MINIMAL/

DID NOT

PERFORM

PERFORMANCE RATING

(Please circle)

FUNCTION 1 – Technology Development Services Instrument Electronics Systems Technology Services VH H M L VL N/R Thermal Control Systems Technology Services VH H M L VL N/R Power Systems Technology Services VH H M L VL N/R Guidance, Navigation and Control (GN&C) Technology Services

VH H M L VL N/R

Cryogenic and Fluids Systems Technology Services VH H M L VL N/R Robotic Technology Services VH H M L VL N/R Autonomous Rendezvous and Docking Services VH H M L VL N/R

FUNCTION 2 – Pre-Formulation and Formulation Studies

System Definition Study Services VH H M L VL N/R

FUNCTION 3 – Implementation Phase Services Mission Systems Engineering VH H M L VL N/R Software Systems Engineering, Studies, Analysis and Support

VH H M L VL N/R

Fabrication, Assembly and Testing Services VH H M L VL N/R Integration, Test, and Verification Services VH H M L VL N/R Mission Assurance and Systems Safety Services VH H M L VL N/R EEE Parts Program Services VH H M L VL N/R

This form contains Source Selection Information when completed. See FAR 3.104. 4

This form contains Source Selection Information when completed. See FAR 3.104. 5

5. General Performance Survey

NO PERFORMANCE QUESTIONS PERFORMANCE RATING

(Please Circle)

QUALITY

1. Quality of services and support provided VH H M L VL N/R

2. Timely identification and mitigation of risks VH H M L VL N/R

3. Ability to identify and correct performance deficiencies in a timely manner VH H M L VL N/R

4. Demonstrated understanding and compliance with mission safety requirements VH H M L VL N/R

Comment:

SCHEDULE

5. Timeliness, quality, and accuracy of schedule estimates and reporting VH H M L VL N/R

6. Ability to meet/exceed schedule milestones VH H M L VL N/R Comment:

COST

7. Ability to establish realistic cost estimates and adhere to estimated costs VH H M L VL N/R

8. Ability to anticipate, identify and control cost growth. VH H M L VL N/R

Comment:

BUSINESS/MANAGEMENT

9. Communicating/interfacing with Government and overall responsiveness to Government requests VH H M L VL N/R

10. Ability to effectively manage the contract including subcontractor performance, if applicable VH H M L VL N/R

11.

Ability to recruit and retain highly skilled personnel, including ability to fill key vacancies in a timely manner.

VH

H

M

L

VL

N/R

12. Adequacy of Contractor’s system(s) for processing task orders and/or changes. VH H M L VL N/R

13. Ability to meet Small Business Subcontracting Plan Goals VH H M L VL N/R

Comment:

This form contains Source Selection Information when completed. See FAR 3.104. 6

Section 6:

What is the Contract Value:

Initial Value Current Value

Estimated Cost: $ $ _

Fee: $ $ _

Total Value: $ $

What are the total contract expenditures to date (cost/fees to date based on invoices, reports, etc)?

What is the Annual Contract Value to Date (The current contract expenditures to date divided by the number of years of performance to date)?

For example (note, these example numbers may not relate to this specific procurement):

Assume your contract is a current five year contract, is still ongoing, and the latest cost report reflects a cost/fee of $43,500,000 through the first 2 years and 4 months (to date). In this example, current/total Contract Expenditures incurred to Date are $43,500,000 and associated period of performance for those expenditures, expressed in years, is 2.33 years.

Therefore, the Average Annual Cost/Fee Incurred to Date: $18,669,528 ($43,500,000/2.33 years)

Was there a cost overrun? ( ) Yes ( ) No If yes, please explain:

If this was an award fee contract, what are the individual and/or average ratings of performance by your organization? Please attach any available award fee letters or database entries.

Please comment on particularly strong/weak points of Contractor’s performance (technical, schedule, and/or cost). If the Overall Contract Performance Rating below is less than Very High, please provide some explanation in this section on why a higher rating was not provided.

Overall Contract Performance Rating (circle one)

Very High High Moderate Low Very Low

If less than Very High Performance Rating, please explain:

This form contains Source Selection Information when completed. See FAR 3.104. 7

Please add any other comments you may feel are pertinent.

Rater’s Signature Date

RFP 80GSFC21R0046