Exhibit 11 - Past Performance Questionnaire.pdf

PDF 180 KB Posted

Attached to
Final RFP - Mars Telecommunications Network (MTN)
Solicitation number
80GSFC26R0011_RFP
Issued by

About this file

This document is a Past Performance Questionnaire template issued by NASA Goddard Space Flight Center, dated 03/19/2026, designed to collect evaluations of contractor performance on completed or ongoing contracts.

The questionnaire consists of six sections. Sections 1-3 gather contract identification information and evaluator credentials, including company name, contract number, period of performance, total contract value, contract type, and evaluator contact details. Section 4 requests relevance ratings across major Statement of Work elements, with evaluators indicating whether contractors performed or did not perform specific work including project management, risk management, systems engineering, spacecraft design and fabrication, integration and test, trajectory planning, launch vehicle interface and integration, launch operations, post-launch vehicle checkout, mission operations, and safety assurance. Section 5 contains 13 performance questions across quality, schedule, cost, and business/management categories, rated on a five-point scale (Very High, High, Moderate, Low, Very Low) or marked as Not Rated. Questions assess service quality, risk identification, deficiency correction, safety compliance, schedule estimates and milestone achievement, cost estimation and control, government communications, subcontractor management, personnel retention, task order processing, and small business subcontracting plan compliance. Section 6 requests contract financial data including initial and current estimated costs and fees, total contract expenditures to date, annual average costs, cost overrun information, award fee ratings if applicable, and commentary on contractor strengths and weaknesses. The questionnaire concludes with an overall contract performance rating and space for additional remarks. Completed questionnaires are to be returned to Ian P. Sherry at NASA Goddard Space Flight Center via email at Ian.P.Sherry@nasa.gov.

View the file

Other files

Show all 21

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Exhibit 12: PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS 03/19/2026

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

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 Attn: Ian P. Sherry, Code 174 Email: Ian.P.Sherry@nasa.gov

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:

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

PAST PERFORMANCE QUESTIONNAIRE

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

ELEMENT PERFORMED DID NOT

PERFORM

Project Management

Risk Management

Systems Engineering

Spacecraft Design/Fabrication:

a. Earth-orbiting mission

b. Deep space / Lunar / Planetary mission

c. Space-based Telecommunications Systems

Spacecraft Integration & Test

a. Earth-orbiting mission

b. Deep space / Lunar / Planetary mission

c. Space-based Telecommunications Systems

Trajectory Planning, Design, and Navigation:

a. Earth-orbiting mission

b. Deep space / Lunar / Planetary mission

Launch Vehicle Interface Design, Analysis, and Test

Launch Site Planning, and Shipping

Launch Vehicle Integration

Launch Operations

Post-Launch Vehicle Checkout:

a. Earth-orbiting mission

b. Deep space / Lunar / Planetary mission

c. Space-based Telecommunications Systems

Mission Operations:

a. Earth-orbiting mission

b. Deep space / Lunar / Planetary mission

c. Space-based Telecommunications Systems

Spacecraft & Mission Design Safety Assurance

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

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

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

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:

Please add any other comments you may feel are pertinent.

Rater’s Signature Date

File details come from the government source that posted it. Updated .