Attachment 0011 - Past Performance Questionnaire.pdf

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Request for Proposal - Materiel Fielding and Medical Liaison Support Services
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This document is a Past Performance Questionnaire used by the US Army ACC-APG Natick Division for a competitive source selection under RFP W911QY-25-R-A001. The questionnaire is designed to assess an offeror's past performance for a contract related to NAICS code 541614, with the goal of evaluating the company's performance across multiple dimensions including product/service compliance, project management, timeliness, cost control, and customer satisfaction.

The document provides a detailed rating scale ranging from "Substantial Confidence" to "No Confidence" and requires respondents to provide rationale for each performance category. The completed questionnaire must be submitted to Contracting Officer Trisha Scott and Contracting Specialist Patrick Wallace by the proposal submission deadline. The evaluation is part of a competitive source selection process for what appears to be a federal contract for materiel fielding and medical liaison support services, with the potential contract award being conducted by the Department of the Army Materiel Command Army Contracting Command at Aberdeen Proving Ground.

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Text version

Performance Assessment Questionnaire – Cover Letter

27 February 2025

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal

(RFP) W911QY-25-R-A001

Dear Sir/Ma’am, The US Army ACC-APG Natick Division is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to the North American Industry Classification System [NAICS] 541614. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation.

Please complete the enclosure and return to ACC-APG-Natick Division, no later than the proposal submission deadline specified in the solicitation. Submit your completed questionnaire to the undersigned Contracting Officer, Trisha Scott, at trisha.r.scott.civ@army.mil, and to the Contracting Specialist, Patrick Wallace, at patrick.j.wallace3.civ@army.mil.

Your cooperation is greatly appreciated. Questions may be directed to the undersigned Contracting Officer, Trisha Scott, at trisha.r.scott.civ@army.mil, and to the Contracting Specialist, Patrick Wallace, at patrick.j.wallace3.civ@army.mil.

Sincerely, Trisha Scott Contracting Officer

DEPARTMENT OF THE ARMY

U.S. ARMY CONTRACTING COMMAND

ABERDEEN PROVING GROUND - NATICK DIVISION

10 GENERAL GREENE AVENUE, BLDG 1

NATICK, MASSACHUSETTS

Performance Assessment Questionnaire

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 and notify the Contracting Officer. 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).

C. Timeliness of Performance for Services and Product Deliverables.

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only) .

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

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.

Untitled

A CONTRACT IDENTIFICATION:
No Confidence:
Rationale 1:
Rationale 2:
Rationale 3:
No Confidence_2:
Rationale 1_2:
Rationale 2_2:
Rationale 3_2:
No Confidence_3:
Rationale 1_3:
Rationale 2_3:
Rationale 3_3:
No Confidence_4:
Rationale 1_4:
Rationale 2_4:
Rationale 3_4:
No Confidence_5:
Rationale 1_5:
Rationale 2_5:
Rationale 3_5:
F General Comments Provide any other relevant performance information:
Comments 1:
Comments 2:
If yes please provide the name and telephone number of a point of contact:
Point of Contact Name:
2025-03-10T13:33:39-0400
SCOTT.TRISHA.RENEE.1506084543

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