A23 04 Sec M Past Perf Questionnaire.pdf

Past Performance Questionnaire (Note: Offerors are not to change the spatial structure of this form, i.e. borders, block size, etc.)

SECTION 1: CONTRACT DATA

Contract Number: Contractor Name:

Contract Title:

Contractor Address:

Contract Value: Contractor DUNS:

Contract Type: Contract Award Date:

Agency/Org.

Name:

Reporting Period (Start):

Place of Performance:

Reporting Period (End):

SECTION 2: DESCRIPTION OF SERVICES

Please provide a brief description of the services provided.

RATINGS

The following ratings and definitions apply to the Quality of Product or Service, Schedule, Cost Control, Business Relations, and Management of Key Personnel factors:

Rating Definition Note

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the

To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.

Satisfactory Performance meets contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

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

To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

N/A N/A (not applicable) should be used if the rating category does not apply

Please explain all ratings of N/A

SECTION 3: EVALUATION FACTORS

1. Quality of Product or Service. 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).

RATING Provide comments on Quality of Product or Service:

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

2. Schedule. Assess the timeliness of the Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or effect the schedule variance).

This assessment of the Contractor's adherence to the required delivery schedule should include the Contractor's efforts during the assessment period that contributes to or effect the schedule variance. This element applies to contract closeout activities as well as contract performance. Instances of adverse actions such as the assessment of liquidated damages, or issuance of Cure Notices, Show Cause Notices, and Delinquency Notices are indicators of problems which may have resulted in variance to the contract schedule and should therefore be noted in the evaluation.

RATING Provide comments on Schedule:

Exceptional

Very Good

Satisfactory

3. Cost Control (Not required for Firm Fixed Price or Firm Fixed Price with Economic Price Adjustment). Assess the Contractor's effectiveness in forecasting, managing, and controlling contract cost. For example, does the Contractor keep within the total estimated cost (what is the relationship of the negotiated costs and budgeted costs to actuals)? Did the Contractor do anything innovative that resulted in cost savings? Were billings current, accurate and complete? Are the Contractor's budgetary internal controls adequate?

RATING Provide comments on Cost Control:

Exceptional

Very Good

Satisfactory

4. Business Relations. Assess the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor's history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

RATING Provide comments on Business Relations:

Exceptional

Very Good

Satisfactory

5. Management of Key Personnel Assess the Contractor's performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

RATING Provide comments on Management of Key Personnel:

Exceptional

Very Good

Satisfactory

6. Utilization of Small Business (Not applicable if contractor is a small business or if the contract did not require a Subcontracting Plan)

RATING Provide comments on Utilization of Small Business:

Exceptional

Very Good

Satisfactory

7. Customer Satisfaction

Was the contractor committed to customer satisfaction? Yes No

Would you recommend the selection of this firm again? Yes No

Provide comments on Customer Satisfaction:

END