Attachment 03 Past Performance Questionnaire - JOC W911S8-21-R-0003 JBLM 20210202.pdf

Source Selection Information – See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

SOURCE SELECTION SENSITIVE INFORMATION

MICC-JBLM PAST PERFORMANCE QUESTIONNAIRE

CONTRACT INFORMATION

(Contractor to Complete Blocks 1 thru 4)

1. Contractor Information Firm Name: CAGE & DUNs Nbr:

Address:

Phone Number: Email Address:

Point of Contact: Contact Phone Nbr:

2. Work Performed As:

Role Contractor Played in Prior Contract: Prime Joint Venture Partner Subcontractor If Subcontractor, who was the Prime:

Proposed Role in Pending Contract: Prime Joint Venture Partner Subcontractor Percent of Project Work Performed:

Length of Time your Agency/Firm has been Involved with the Offeror:

3. Contract Information:

Contract Number: Award Date (mm/dd/yyy):

Delivery/Task Order Number (if applicable):

Contract Type (Firm Fixed Price, Cost Reimbursement, Other (Please Specify)):

Contract Title:

Contract Completion Date (mm/dd/yyyy): Actual Completion Date (mm/dd/yyyy):

Explain Difference:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Difference:

4. Project Description Complexity of Work: High Medium Low Description of Work:

How is this project relevant to project of submission (Please provide details such as similar equipment, requirements, conditions, etc.):

5. Evaluator Information (Evaluator to Complete Blocks 5 thru 8) Name: Title:

Phone Nbr: Email Address:

Describe your role in the project:

Date Questionnaire Completed (mm/dd/yyyy):

Evaluator’s Signature:

ADJECTIVAL RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE

CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner.

A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

(VG) Very Good Performance meets contractual requirements and exceeds some to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been NO significant weaknesses identified.

(S) Satisfactory Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) Marginal Performance does not meet some contractual requirements.

The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner.

(U) Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

(NA) Not Applicable No information or did not apply to your contract. Rating will be neither positive nor negative.

Contractor Information (Firm Name):

Evaluator Information (Name):

TO BE COMPLETED BY EVALUATOR

Please mark the appropriate block which best reflects your evaluation of the contractor’s performance

CONTRACTOR PAST PERFORMANCE

EVALUATION SURVEY

N/ A

Un sa tis fac tor y

Ma rg ina l

Sa tis fac tor y

Ve ry

Go od

Ex ce pti on al

1. Technical/Quality of Service

a) The Contractor provided a product or service that conformed to contract requirements, specifications, and standards of good workmanship.

b) The Contractor’s quality of submitted technical data/reports

c) The Contractor utilized personnel that were appropriate to the effort performed

d) The Contractor maintained an adequate and effective quality control program and adhered to contract quality control assurance requirements (without adverse effects on performance)

2. Cost Control

a) The Contractor performed the effort within the estimated cost/price.

b) The Contractor submitted accurate invoices on a timely basis.

c) The Contractor demonstrated cost efficiencies in performing the required effort.

d) The Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the Government.

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below

f) The actual costs/rates realized closely reflected the negotiated costs/rates.

g) The Contractor maintained adequate financial resources and has not shown any signs of financial difficulty during performance of this effort. If difficulties occurred, please explain in comment section below.

3. Schedule/Timelines

a) The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract. (If liquidated damages were assessed or the schedule was not met, please address in comment section below)

b) Rate the Contractor’s use of available resources to accomplish tasks identified in the contract.

c) The Contract was responsive to technical and/or contractual direction.

4. Management/Business Relations

a) The Contractor demonstrated effective management of on-site management, subcontractors, suppliers, materials, and/or labor force.

b) The Contractor demonstrated the ability to hire, apply, and retain qualified workforce for this effort.

c) The Contractor demonstrated the knowledge and expertise required for this effort.

d) The Contractor demonstrated the ability to simultaneously manage multiple projects with multiple disciplines.

e) The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) and/or Technical Point of Contact (TPOC) were apprised of technical, cost, and schedule issues.

f) The Contractor presented information and correspondence in a clear, concise, and business-like manner.

g) The Contractor promptly notified the COR, TPOC, and/or Contracting Officer in a timely manner regarding urgent issues.

h) The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical issues.

i) The Contractor made timely award to, and demonstrated effective management of, its subcontractors.

j) The labor turnover in key personnel labor categories was minimal and did not adversely affect Contractor performance.

k) The Contractor proposed qualified personnel to fulfill the requirements of the contract.

5. Regulatory Compliance

a) The Contractor maintained an environment of safety, adhered to its approved safety plan, and responded to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

b) The Contractor complied with all security requirements for the project and personnel security requirements.

6. Other

a) To what extent were the end users satisfied with the project?

b) The Contractor was reasonable and cooperative in dealing with your staff.

c) The Contractor was able to perform with minimal or no direction from the COR or the TPOC.

d) In summary, provide an overall rating for the work performed by this contractor.

Comments Section:

NOTE: For ratings indicating less than “Satisfactory” or above “Satisfactory”, a narrative supporting the reason for the rating must be provided in the comments section below.