Attachment 1 Performance Assessment Questionnaire.pdf

PDF 276 KB Posted

Attached to
Satellite Television Services Solicitation Federal contract opportunity
Solicitation number
W912L1-22-Q-0016
Issued by
Department of the Army Texas Army National Guard

About this file

This document contains a performance assessment questionnaire for evaluating offerors in response to solicitation number W912L1-22-Q-0016 for satellite television services throughout Texas issued by the Department of the Army Texas Army National Guard. The questionnaire is to be completed by previous customers identified by offerors and requests ratings and rationales on compliance with requirements, project management, timeliness, cost controls if applicable, and commitment to customer satisfaction for same or similar prior contracts. Respondents are also asked to provide their name, organization, and any other relevant past performance information on the offeror. Completed questionnaires are to be returned to the contracting officer by June 3rd, 2022 to be considered in the source selection.

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Text version

Performance Assessment Questionnaire – Cover Letter

USPFO for Texas 05/1/2022

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

(RFQ) W912L1-22-Q-0016

Dear Sir/Ma’am, The US Army TXARNG is currently conducting a competitive solicitation to evaluate offerors on the subject RFQ. As part of this evaluation, we have requested that the offerors provide information about their past performance on same or similar federal, state, or local government or commercial contracts as compared to the North American Industry Classification System [NAICS] 517410, Satellite Telecommunications. 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 the USPFO for Texas, 2200 West 35th St, Austin, TX 78703, no later than 10 days after receipt of request or 06/03/2022, whichever occurs first. Submit your completed questionnaire to Horacio.Fernandez3.civ@army.mil.

Your cooperation is greatly appreciated. Questions may be directed to the undersigned at Horacio.Fernandez3.civ@army.mil.

Sincerely, Horacio Fernandez Contracting Officer mailto:Horacio.Fernandez3.civ@army.mil mailto:Denise.M.Bailey.civ@army.mil mailto:Denise.M.Bailey.civ@army.mil

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).

Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence

Rationale: __________________________________________________________

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

Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence

Rationale: __________________________________________________________

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

Substantial Confidence Satisfactory Confidence 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.

Performance Assessment Questionnaire Cover Letter:
A CONTRACT IDENTIFICATION:
No Confidence:
Rationale 1:
Rationale 2:
Rationale 3:
Rationale 4:
Rationale 5:
No Confidence_2:
Rationale 1_2:
Rationale 2_2:
Rationale 3_2:
Rationale 4_2:
Rationale 5_2:
No Confidence_3:
Rationale 1_3:
Rationale 2_3:
Rationale 3_3:
Rationale 4_3:
Rationale 5_3:
No Confidence_4:
Rationale 1_4:
Rationale 2_4:
Rationale 3_4:
Rationale 4_4:
Rationale 5_4:
No Confidence_5:
Rationale 1_5:
Rationale 2_5:
Rationale 3_5:
Rationale 4_5:
Rationale 5_5:
F General Comments Provide any other relevant performance information:
Comments 1:
Comments 2:
Comments 3:
Comments 4:
Comments 5:
If yes please provide the name and telephone number of a point of contact:
Point of Contact Name:
2022-05-01T15:49:21-0500
FERNANDEZ.HORACIO.1252291381

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