Append_C - Past Performance Questionnaire_SOC_Ev2.pdf

APPENDIX C

PAST PERFORMANCE QUESTIONNAIRE

**When completed, this document is Source Selection Information IAW FAR 3.104**

SECTION 1: CONTRACT IDENTIFICATION (TO BE COMPLETED BY OFFEROR)

A. Contractor __________________________________________________________________________

B. Contractor Cage Code_________________________________________________________________

C. Role (check): Prime Subcontractor Teaming Partner Joint Venture Partner Other (specify) _______________________________________________________

If subcontractor, partner or other, who is the Prime? _____________________________

D. Contract Number_____________________________________________________________________

E. Subcontractor Number _________________________________________________________________

F. Contract Type _______________________________________________________________________

G. Period of Performance

H. Place(s) of Performance (CONUS, OCONUS)

I. Annual Contract $ Value

J. Description of Service(s) provided (Provide details on type of work, locations worked, and organizations serviced, to include Department of Defense, Government, or commercial work)

*****FOLLOWING SECTIONS COMPLETED BY PRIME CONTRACTOR*****

SECTION 2: CUSTOMER IDENTIFICATION (Buying Organization)

A. Customer Name

B. Customer Description

SECTION 3: EVALUATOR IDENTIFICATION

A. Name _________________________________________ B. Title_____________________________

C. Phone/Fax D. E-mail

E. Years worked on Subject Contract

APPENDIX C - SOC E PAST PERFORMANCE

QUESTIONNAIRE

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG

VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or was satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

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

N/A NOT APPLICABLE - Unable to provide a score or item is not applicable to the referenced contract.

Please answers the following questions below by selecting the applicable drop down option.

1. Ability of contractor to meet PWS requirements without deviations.

2. Over the period of the referenced contract, how often did contractor request waivers?

Base

OY1

OY2

OY3

OY4

3. Ability of Contractor to adhere to regulatory guidance, technical data and all other technical guidance.

4. Ability of contractor to provide deliverable/reports required by the contract on time.

5. Ability of contractor to meet contract schedule requirements.

6. How many Corrective Action Reports and/or First Notices were issued within each year of the contract?

Base

OY1

APPENDIX C - SOC E PAST PERFORMANCE

QUESTIONNAIRE

OY2

OY3

OY4

7. When problems in performance were/are encountered, ability of contractor to overcome the problems.

8. Ability of contractor to provide a qualified workforce at the performance start of the referenced effort.

9. Ability of the contractor to retain qualified workforce over the period of the referenced effort.

10. Ability of contractor to fill vacancies with a qualified workforce over the period of the referenced effort.

11. How many vacancies were there during the lifetime of the contract:

Base

OY1

OY2

OY3

OY4

12. Contractor’s overall Program Management.

13. Ability of the contractor to respond/maintain communication with the Government.

14. Were there significant issues with invoicing over the period of the referenced effort?

15. Would you have any reservations about having this contractor perform again on one of your critical and demanding programs?

SECTION 5: NARRATIVE SUMMARY

A. Was this contract partially or completely terminated for default or convenience or is there any pending terminations?

(Place an “X” by all that apply.)

Yes No Default Convenience Pending Terminations

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.).

Yes No

APPENDIX C - SOC E PAST PERFORMANCE QUESTIONNAIRE

B. Other narrative comments to support your ratings:

Evaluator’s Signature Date