AB-133E-16-RP-0022_Attachment_7_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

AB-133E-16-RP-0022

National Oceanic Atmospheric Administration (NOAA) NESDIS HQ Administrative, Technical, and Non-Scientific Support Services

Offeror/Contractor: Please complete Part 1 and provide each reference/evaluator with the form.

Reference/Evaluator: Please complete Part 2 and provide your candid responses. The information you provide will be used in the evaluation of the offeror/contractor for potential award of a federal contract or agreement; therefore it is important that your information is factual, accurate, and complete as possible. If you do not have knowledge of or experience with the company in question, please forward to the person who does.

Please submit the completed survey by email (preferred) prior to 2:00 PM (PT) on Monday, March 7, 2016.

NOAA Western Acquisition Division email: galeeb.kachra@noaa.gov Attn: Galeeb Kachra - Affiliate 7600 Sand Point Way NE SOU6 Seattle, WA 98115

PART 1: (TO BE COMPLETED BY THE OFFEROR/CONTRACTOR)

A. NAME OF OFFEROR/COMPANY BEING EVALUATED:

B. NAME/ADDRESS OF COMPANY PROVIDING EVALUATION INFORMATION:

Company Name:

Evaluator's Name and Title:

Address:

Telephone No.: E-mail Address:

C. PROJECT INFORMATION

(Under Work Description, include similarities/relevance to solicitation project AND a description of work performed.)

Contract No.:

Project Title/Location:

Work Description:

Contract Type:

Original Contract Price:

Final Contract Price:

Original Completion Date:

Forecasted/Actual Completion Date:

Work was with: Commercial ____ Fed. Gov't ____ Local/City/State Gov't ____

(END OF PART 1)

**PART 2: EVALUATION

(INFORMATION TO BE COMPLETED BY THE CUSTOMER REFERENCE RESPONDING FOR THE OFFEROR)**:

For each performance element identified below, references should evaluate performance of the firm or individual identified in Part 1 of this form. Where the reference lacks sufficient information to provide an evaluation for a particular performance element, this should be noted. Where any deficiency or unfavorable information is identified, the reference should identify any mitigating factors that may weigh in favor for the person/firm on whose behalf the reference is provided (i.e., problems due to causes outside the contractor's control). An individual within your organization that is knowledgeable of the contractor's day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor's (offeror's) performance with the judgment of others within their organization, as applicable.

The following chart depicts the ratings that are to be used to evaluate the contractor's performance:

Based on the offeror's exceptional performance record, no doubt exists that they offeror will successfully perform the required effort.

VERY LOW PERFORMANCE RISK

Based on the offeror's very good performance record, little doubt exists that the offeror will successfully perform the required effort.

LOW PERFORMANCE RISK

Based on the offeror's satisfactory but not otherwise exemplary performance record, some doubt exists that they offeror will successfully perform the required effort. Normal contractor emphasis should preclude any problems.

MODERATE PERFORMANCE RISK

Based on the offeror's marginal performance records, substantial doubt exists that the offeror will successfully perform the required effort.

HIGH PERFORMANCE RISK

Based on the offeror's poor performance record, extreme doubt exists that the offeror will successfully perform the required effort.

VERY HIGH PERFORMANCE RISK

NOTE: UNKNOWN RISK WOULD BE THE EQUIVALENT TO THE EVALUATOR PROVIDING A "NOT APPLICABLE (N/A)" TO ANY OF THE QUESTIONS.

When responding to the questions listed, circle or highlight the letter that most accurately describes the contractor's performance or situation. Alternatively, delete or strikethrough the other letters e.g., E VG S M U N/A. For any poor rating, please provide explanatory narratives in the remarks block. These narratives need not be lengthy, just detailed. If a question is not applicable, circle N/A. If you circle a Yes or No answer that is marked with an asterisk (*), please provide a corresponding explanation in the remarks block. If more space is required, use the back of the questionnaire or attach additional pages. Handwritten responses to this questionnaire that are scanned and emailed are acceptable. However, if responses are handwritten, please print legibly.

Your time and effort in providing this information is vitally important and is greatly appreciated.

***Failure to provide an explanation to "exceptional," "marginal," or "unsatisfactory" ratings may result in a lower rating.

QUALITY OF SERVICE

BUSINESS RELATIONS

MANAGEMENT OF KEY PERSONNEL

COMPLIANCE WITH LABOR, ENVIRONMENTAL SAFETY, HEALTH

AND SECURITY REQUIREMENTS

COST MANAGEMENT

CONTRACTUAL CONSIDERATIONS

*REMARKS

Are you aware of other relevant past services performed by this company?

If yes, please provide the name and telephone number of a point of contact.