A23.6 Attachment 6 - Past Performance Questionnaire.rtf

HQ084721Q0003

Attachment 5

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Instructions to Offerors Sending Reference Questionnaire Forms:

The Government requests that the offeror provide up to three (3) past performance contract references that reflect recent and relevant experience. Section A shall be completed by the offeror (the firm requesting the reference) prior to issuing the questionnaires. The offeror shall send the questionnaires for relevant projects completed in the past five (5) years of the quote due date to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for Government contracts. It is the responsibility of the offeror to follow-up and encourage references to submit the questionnaire. The completed questionnaire shall be submitted via e-mail directly from the person providing the reference to the contracting office.

Instructions to Person Providing Reference:

In order to assess potential vendors under the Washington Headquarters Service / Acquisition Directorate (WHS/AD), Video Wall Display Upgrade, Solicitation Number HQ084721Q0003, WHS seeks past performance information with respect to each Offeror. As a reference for work performed by the firm identified in Section “A” of this questionnaire, your candid response will assist in the evaluation process. Please complete Section “B” of the questionnaire as thoroughly as possible. Please email your completed questionnaire to Contract Specialist Steven Dyer, steven.g.dyer3.civ@mail.mil and Contracting Officer Tara Murphy at tara.k.murphy.civ@mail.mil no later than July 20th, 2021. Please annotate the subject line in the e-mail as: ‘Video Wall Display Upgrade - Past Performance Questionnaire (Company Name)’. Emails shall originate from the reference’s government or commercial e-mail system.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is an important WHS/AD acquisition and your input into this evaluation is greatly appreciated. If you have questions regarding this questionnaire or require assistance, please submit inquiries to Contract Specialist Steven Dyer, steven.g.dyer3.civ@mail.mil and Contracting Officer Tara Murphy at tara.k.murphy.civ@mail.mil" tara.k.murphy.civ@mail.mil.

Sincerely, Tara K. Murphy Contracting Officer

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: HQ084720R0007 MSA with MSA Levantine and MSA Moroccan Language Instruction Services

OFFEROR INFORMATION

COMPANY NAME AND DIVISION NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):

TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID):

PRICING TYPE: (Circle / check all that apply)

FP FPI CPFF CPAF CPIF IDIQ BOA

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HQ084721Q0003

Attachment 5

Requirements Labor-Hour T&M Other (Specify)

DATE OF AWARD:

CONTRACT START and END DATE (Including options if applicable):

CONTRACT VALUE / AMOUNT (Including options if applicable):

ROLE ON PROJECT: PRIME

SUBCONTRACTOR (EXPLAIN TYPEAND EXTENT OF SUBCONTRACTING, IF APPLICABLE): OTHER (EXPLAIN)

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE (e.g. CO, COR, PM):

ADDRESS:

PHONE NUMBER:

E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A.

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Performance Element

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

1. QUALITY OF HARDWARE PROVIDED. Assess the quality of the hardware and supporting components provided. Salient characteristics, requirements, specifications, compatibility and standards).

Comments:

Performance Element

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

2. INSTALLATION and SCHEDULE PLAN Assess the Contractor’s technical approach and capability to meet the project’s installation and schedule plan against the timeline of the contract (e.g. efforts that contribute to or affect the schedule).

3. MAINTENANCE APPROACH

Assess the contractor’s effectiveness in providing emergency and scheduled maintenance of the installed hardware / system (easy to contact, response time, timely resolution, effectiveness of contractor’s maintenance approach).

4. TRAINING APPROACH

Assess the contractor’s approach to training personnel to familiarize themselves to maintain the hardware, address minor issues outside of emergency and scheduled maintenance, personnel’s confidence to operate equipment after training).

5. BUSINESS RELATIONS

Assess the integration and coordination of all activities 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 subcontractors.

7. Comments:

8. Additional comments you would like to share

Signature/Date