Exhibit 6 - L10 Past Performance Questionnaire R.pdf
PDF 195 KB Posted
- Attached to
- Landsat 10 Spacecraft _ DRAFT RFP
- Solicitation number
- 80GSFC26D0015
About this file
This is a Past Performance Questionnaire template used by NASA Goddard Space Flight Center to evaluate contractor performance on completed or ongoing contracts. The form is designated as Source Selection Information under FAR 3.104 and must be returned by July 30, 2026, to Pavithra S. Tumbapura at NASA Goddard Space Flight Center in Greenbelt, Maryland.
The questionnaire is structured in six sections designed to comprehensively assess contractor capabilities and past performance. Section 1 collects basic contract information including contractor name, address, CAGE code, contract number, type, period of performance, and total contract value, along with award details and basis of selection. Section 2 requests a brief description of services provided and identifies the contractor's role (prime contractor, significant subcontractor, or team member). Section 3 captures evaluator identification and credentials. Section 4 requires assessment of relevant experience across 19 major spacecraft project work elements covering project management, systems engineering, design and fabrication, mission readiness, integration and testing, operations, and safety assurance, with evaluators indicating whether each element was performed or not performed under the contract being referenced.
Section 5 evaluates 13 performance factors across quality, schedule, cost, and business/management categories using a five-point scale (Very High, High, Moderate, Low, Very Low, or Not Rated). Quality factors address service delivery, risk mitigation, deficiency correction, and safety compliance. Schedule factors assess estimate accuracy and milestone achievement. Cost factors evaluate estimate reliability and cost growth management. Business/management factors address government communication, contract management, personnel retention, task order processing, and small business subcontracting plan compliance. Section 6 documents contract financial data including initial and current estimated costs, fees, total values, expenditures to date, average annual costs, cost overruns, award fee ratings if applicable, and requires narrative comments on contractor strengths and weaknesses with justification if overall performance rating falls below Very High. The form concludes with signature and date requirements from the evaluator.
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Text version
This form contains Source Selection Information when completed. See FAR 3.104. 1
PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS
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.
Section 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
This form contains Source Selection Information when completed. See FAR 3.104. 2
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 7/30/2026. Attn: Pavi Tumbapura, Code 178.
Greenbelt, MD 20771 Phone: 301-286-0855 e-mail: pavithra.s.tumbapura@nasa.gov
This form contains Source Selection Information when completed. See FAR 3.104. 3
PAST PERFORMANCE QUESTIONNAIRE
1. Contract 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:
This form contains Source Selection Information when completed. See FAR 3.104. 4
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. Evaluator Information
Name:
Title:
Agency/Company:
E-mail Address:
Phone: Date Questionnaire Completed:
Role in Program/Contract:
Length of Involvement in this Program/ Contract:
This form contains Source Selection Information when completed. See FAR 3.104. 5
4. SOW Survey Relevance Ratings: Please check the appropriate blocks for Relevance (Performed or Did Not Perform)
SOW ELEMENT PERFORMED DID NOT PERFORM
Spacecraft Project Management
Spacecraft Project/Schedule Management
Spacecraft Risk Management
Spacecraft Systems Engineering
Spacecraft Systems Engineering Management
Verification and Validation
Technical Reviews Spacecraft Systems Design and Fabrication
Subsystem Design and Fabrication Instrument Interface Design, Definition, and Test
Launch Vehicle Interface Design, Definition, and Test
Mission Readiness Planning/Execution
Spacecraft Simulator Development and Maintenance
Mission Readiness Testing
Operations Planning
On-Orbit Commissioning
Launch Site Planning, Shipping, Operations
Spacecraft/Observatory Integration & Test
Integration and Test of GFE Instrument/Payload
Spacecraft Safety and Mission Assurance
This form contains Source Selection Information when completed. See FAR 3.104. 6
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
This form contains Source Selection Information when completed. See FAR 3.104. 7
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:
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:
This form contains Source Selection Information when completed. See FAR 3.104. 8
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:
Please add any other comments you may feel are pertinent.
Rater’s Signature Date
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