Attachment 1-Past Performance Questionnaire.pdf

RFP 80LARC26R0002

Attachment 1 – Past Performance Questionnaire

This form contains Source Selection Information when completed; see FAR 3.104.

NASA Langley Research Center

Geostationary Littoral Imaging Monitoring Radiometer (GLIMR) Access to Space (ATS)

This evaluation should be completed by the contracting officer (CO), contracting officer’s representative

(COR), task monitor (TM), or other person(s) tasked with monitoring and knowledgeable of the contractor’s or subcontractor’s compliance with the requirements of the contract.

In compliance with the direction in the FAR, the information contained in this evaluation is not subject to view by anyone other than the designated source selection evaluation personnel.

INSTRUCTIONS, DEFINITIONS, AND RATING GUIDELINES

Instructions

This evaluation is to be completed as indicated below. For purposes of this evaluation, the term

“project” is intended to mean “contract.” This package consists of the following:

Section Description Who completes the form or report

Section I Basic contract information Contractor being evaluated

Section II Government /Industry customer evaluator identifying information

Government /Industry customer evaluator

Section III Contractor Performance Report Government/Industry customer evaluator

The offeror is responsible for completing Section A. of this questionnaire before forwarding it to the appropriate POC for the evaluations requested. For each contract selected, a single comprehensive assessment is requested (e.g., an assessment with input from the appropriate CO, cognizant COR, and/or other designee).

In addition, the offeror shall request the evaluator to complete the remainder of the questionnaire and email directly to Ashley Korahaes at larc-glimr-ats@mail.nasa.gov.

Any questions concerning the completion of this form should be addressed to Ashley Korahaes at larc-glimr-ats@mail.nasa.gov.

mailto:larc-glimr-ats@mail.nasa.gov

This form contains Source Selection Information when completed; see FAR 3.104.

EXAMPLE PAST PERFORMANCE FORM LETTER/EMAIL FOR OFFERORS USE AS A COVER FOR

QUESTIONNAIRE

(Date of Letter) (Name and Address of proposed offeror’s customer) Attention: (Name and Designation of Customer’s Contract Manager or Appropriate Contact)

Subject: NASA Langley Research Center Request for Proposal (RFP)

Dear (Contact Name): We are currently responding to a NASA Langley Research Center (LaRC) solicitation for . We have identified our work for your agency as a past performance reference.

The Government requested, when possible, to have the evaluation jointly completed by the Technical Customer and Contracting Officer. Per the solicitation instruction, please complete the enclosed Past Performance Questionnaire (PPQ) and return the signed, completed document to the NASA Contracting Specialist listed below No Later Than 2:00PM Eastern Time on August 11, 2026.

Preferable Method of Transmission is via email in Adobe PDF format to the Contract Specialist, Ashley Korahaes at larc-glimr-ats@mail.nasa.gov.

In the event you are contacted for information on work we have performed either on this effort or other efforts, you are hereby authorized to respond to those inquires. Your cooperation with this effort is greatly appreciated. Please direct any questions to (Name and Phone Number of Offeror’s Point-of-Contact).

In order to maintain the integrity of this process, please DO NOT return the questionnaire to us.

Return it to NASA LaRC at the address listed above.

Solicitation No. DUE: (Date to be filled in by Offerors— No later than the date listed on the cover page of this questionnaire)

Sincerely, This form contains Source Selection Information when completed; see FAR 3.104.

RFP 80LARC26R0002

Attachment 1 – Past Performance Questionnaire

Please send completed questionnaire directly to the NASA Contract Specialist at the email address below (do not return questionnaire to the Offeror):

Ashley Korahaes, by Adobe PDF file to: larc-glimr-ats@mail.nasa.gov

Section I – Contract Information: To Be Completed By the Offeror

Sections II through IV: To Be Completed by Reference(s). If possible, please ensure the questionnaire is jointly completed by the Technical Customer and Contracting Officer (CO). In addition, it would be greatly appreciated if you would also forward any existing Past Performance Information

(e.g., Contractor Performance Assessment Reports [CPARS]) for the contractor being assessed that you feel is relevant to our effort within 5 years of July 22, 2026.

For Sections III & IV, please use the following definitions (from CPARS definitions) to assign a performance rating for each of the questions:

• Exceptional (E) Performance meets contractual requirements and exceeds many to the

Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

• Very Good (VG) Performance meets contractual requirements and exceeds some to the

Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

• Satisfactory (S) Performance meets 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.

• Marginal (M) Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated 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.

• Unsatisfactory (U) 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 a serious problem(s) for which the contractor's corrective actions appear or were ineffective.

• Not Applicable (N/A)

For Section III, in addition to rating performance please rate the amount of work that the contractor performed under your contract in each area assessed using the following ratings:

• Significant Amount (Sig) -- Routinely performed the full range of services for the critical SOW areas.

• Moderate Amount (Mod) -- Performed several aspects of the critical SOW areas with moderate frequency.

• Minimal Amount (Min) -- Performed at least some aspects of the critical SOW areas , although such performance was limited in scope or frequency.

• Not Applicable (NA) -- Did not perform the critical SOW areas under your contract.

This form contains Source Selection Information when completed; see FAR 3.104.

I. CONTRACT INFORMATION (OFFERORS COMPLETE SECTION I ONLY):

A. Company Being Evaluated and Contract Information:

Company Name (Specific Division)

Company Address

Cage Code and UIE number

Contract/Order Number

Total Contract/Order Value

(including all options, exercised and unexercised)

Total actual obligated dollars $

Period of Performance Start Date: End Date:

Description of Work Performed

Percentage of work performed/responsible for

(applicable if past performance is for subcontract performance only)

Award/Incentive Fee (provide ratings that the contractor received over the past 3 years), if applicable

Rating Period: Rating:

Rating Period: Rating:

Rating Period: Rating:

Rating Period: Rating:

Rating Period: Rating:

Rating Period: Rating:

B. Contract Type (Check all that apply):

Check all that apply: Check all that apply:

Prime Contractor Firm Fixed Price

Subcontractor Cost Plus Fixed Fee

Joint Venture Partner/ Team

Member

Cost Plus Award Fee

Other: ___________ Cost Plus Incentive Fee

Time & Materials

Other: _______________

This form contains Source Selection Information when completed; see FAR 3.104.

II. CUSTOMER EVALUATION: *To be completed by the Government and/or Industry customer performing the evaluation

*If possible, please ensure the Technical Customer and CO jointly complete/coordinate on the questionnaire.

Evaluator’s Name(s)

Title(s)

Agency/Organization

Email Address

Phone Number

Role in Program/Contract

Length of Involvement in contract (dates)

Date PPQ completed

III. PERFORMANCE RATINGS & AMOUNT OF WORK PERFORMED (i.e., RELEVANCE):

Circle the rating for the appropriate blocks for both “Performance” and “Amount of Work Performed” for each element listed below using the adjective ratings and definitions above:

ELEMENT

PERFORMANCE

RATINGS

From High To Low

E, VG, S, M, U, N/A

(Please Circle One)

AMOUNT OF WORK

PERFORMED

From High To Low

Sig, Mod, Min, NA

(Please Circle One)

Contractor’s performance in providing/achieving and maintaining the required orbital parameters.

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in maintaining required contamination control (e.g., with an optical instrument).

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in providing integration, test, and pre-launch processing.

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in performing ground system design, integration, testing, and readiness.

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in providing a spacecraft bus and/or launch vehicle.

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in providing checkout and operations (e.g., pointing knowledge; control; and stability).

E VG S M U NA SIG MOD MIN NA

This form contains Source Selection Information when completed; see FAR 3.104.

Contractor’s ground system and data delivery performance (e.g., timeliness;

quality problem resolution).

E VG S M U NA SIG MOD MIN NA

Contractor’s performance in meeting and supporting various design reviews (e.g., PDR, CDR).

E VG S M U NA SIG MOD MIN NA

IV. General Performance Ratings: Assess the Contractor’s general performance in the areas identified below. Additional pages may be used for comments if desired. Please keep in mind that only performance in the past 5 years from July 22, 2026 is relevant. If you cannot answer any questions, please circle Not Applicable (NA).

GENERAL PERFORMANCE QUESTIONS

PERFORMANCE RATING

From High To Low

E, VG, S, M, U, NA

(Please Circle One)

1. Quality of Product or Service E VG S M U NA

2. Schedule E VG S M U NA

3. Business Relations E VG S M U NA

4. Utilization of Small Business E VG S M U NA

5.

Rate the contractor’s overall performance under this contract

E VG S M U NA

Please provide comments: