Att L-4 PPQ 08-13-20.docx

N6134020R0082 Attachment L-4

SOURCE SELECTION INFORMATION-SEE FAR 2.101 AND 3.104

L-4 Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACT ADMINISTRATIVE DATA (To be completed by the Offeror) Offeror Name:

Offeror Role in Past Performance Contract:

Contract Title:

Contract Number/Task Order:

Contract Type:

Procuring Agency:

Description of Product or Service:

Period of Performance:

Dollar Value of Contract:

Current Dollar Value of Effort:

Administrative Place of Contract:

Cage Code:

DUNS:

Customer:

Contracting Agency:

II. POINT OF CONTACT (POC) Data (To be completed by the Offeror) Name:

Position or role:

Agency:

Address:

Phone:

Email:

Other:

III. INFORMATION TO THE PPQ POC

Your assistance is requested in support of a source selection. Please complete the assessment below and send all pages of this questionnaire to: Kelly.stevens@navy.mil with copy to Mr. Rafael Soberal at rafael.soberal@navy.mil.

Assessment: (To be completed by the PPQ POC)

Instructions to complete the assessment: Please provide responses to items 1 through 6 that are listed below. Utilizing the Rating System Table place an “X” in the rating that best assesses the offeror’s performance in the areas listed below. Then provide examples to substantiate your rating based on the ratings in the Rating System Table. For example, if you provide a rating of ‘Exceptional’, list the “many” contractual requirements that were exceeded “to the government’s benefit”.

Rating System Table:

A common five level assessment rating system is used to evaluate a contractor's performance. Ratings range from Unsatisfactory to Exceptional. Here's a breakdown of each category:

1. PROGRAM CHARACTERISTICS

Please provide a short description of the effort and the offeror’s role in its performance:

2. Quality of Product or Service:

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

N/A

List the positive and negative examples that substantiate rating IAW the ratings from the Ratings System Table above:

3. Schedule:

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

N/A

List the positive and negative examples that substantiate rating IAW the ratings from the Ratings System Table above:

4. Management (Program Management, Subcontract Management, and Cooperation with Customer):

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

N/A

List the positive and negative examples that substantiate rating IAW the ratings from the Ratings System Table above:

5. Systemic Improvement – Please provide comments related to demonstrated systemic improvement actions taken to resolve any past problems.

6. Given what I know today about the contractor's ability to execute what he promised in his proposal, I WOULD or WOULD NOT award to him today given that I had a choice.

Signature ______________________________ Date _____________ Electronic signatures are acceptable. An e-mail from the originator of this document will suffice. Signatures (electronic or hand written) verify that the signatory completed this form and agrees with the information.

SOURCE SELECTION SENSITIVE FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION-SEE FAR 2.101 AND 3.104

SOURCE SELECTION INFORMATION-SEE FAR 2.101 AND 3.104