Attach 0006 PPQ - 13 JUL 2026.docx

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Security Assistance Mentors and Cultural Advisors (SAMA) SAMA 3. 0 for USMILGP-Iraq
Solicitation number
W519TC-26-R-A024
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About this file

This is a Performance Assessment Questionnaire template designed to evaluate contractor past performance on federal contracts. The questionnaire is to be completed by references or points of contact familiar with a contractor's previous work and submitted to the Contracting Officer within a specified timeframe. The form applies to the SAMA 3.0 (Security Assistance Mentors and Cultural Advisors) solicitation W519TC-26-R-A024 issued by the Department of the Army Materiel Command Contracting Command Rock Island Arsenal, with an evaluation date of July 13, 2026.

The questionnaire evaluates contractor performance across six key dimensions using a four-tier rating scale: Compliance of Products, Services, Documents, and Deliverables to Specification Requirements; Effectiveness of Project Management including subcontractor control; Timeliness of Performance for Services and Product Deliverables; Effectiveness in Forecasting and Controlling Estimated Costs; Commitment to Customer Satisfaction and Business-like Concern for Customers' Interests; and General Comments. Each response requires supporting rationale. The form collects contract identification information (contractor name, contract number, award date, total contract value, nature of effort), offeror representative identification, respondent information, and references to other relevant past efforts by the company. Responses range from "Substantial Confidence" (performance exceeds many requirements with few minor issues) to "No Confidence" (performance does not meet most contractual requirements with ineffective corrective actions).

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Performance Assessment Questionnaire

[Questionnaire should include questions to assess compliance with FAR 52.219-8 and FAR 52.219-9.]

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Substantial Confidence

· Satisfactory Confidence

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

D. Effectiveness in Forecasting and Controlling Estimated Costs.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

F. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

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

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

File details come from the government source that posted it. Updated .