ATTACHMENT 15 - Past Performance Questionnaire - 5 Pages.docx

SP3300-24-R-0002

Attachment 13

(WHEN COMPLETED)

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Present/Past Performance Questionnaire

PART I – BACKGROUND

The RFP has been issued to solicit offers that would provide the best value to the Government for the requirements of the procurement. The specific RFP requirements may be referenced at www.sam.gov. The place of performance for this acquisition is DLA Distribution Susquehanna, Pennsylvania (DDSP) located in New Cumberland, PA and the customer for this contract is DDSP Facilities Engineering Branch, also sited at New Cumberland, PA. The anticipated contract will be for various construction/building related efforts. A company that is interested in providing an offer on the RFP has requested that your firm complete this present/past performance questionnaire and submit it to the following:

Mogen Gilson, Acquisition Specialist at Mogen.gilson@dla.mil by the due date and time specified in the solicitation.

All completed questionnaires shall be submitted via email to the Acquisition Specialist noted above by the proposal due date and time referenced in the solicitation.

PART II – RELEVANT PREVIOUS CONTRACT GENERAL INFORMATION

The following information is to be completed by the Rater/Evaluator/Assessing Official (AO):

Contract Number: AO click here to enter contract number.

Contract Type: AO click here to enter contract type.

Contract Original Dollar Amount: AO click here to enter original dollar amount.

Contract Current Dollar Amount: AO click here to enter current dollar amount.

Program Identification/Title: AO click here to enter program title.

Prime Contractor Name (if this was a subcontract effort): AO click here to enter prime contractor name.

If Subcontractor to Prime Contractor, Percentage of Level of Effort in Prime Contract:

AO click here to enter percentage.

Contractor/Company Name/Division: AO click here to enter company name/division.

Contract Place of Performance (Address): AO click here to enter place of performance.

Contract Award Date: AO click here to enter contract award date.

Contract Original Period of Performance: AO click here to enter original period of performance.

Contract Current Period of Performance: AO click here to enter current period of performance.

Forecasted or Actual Contract Completion Date: AO click here to enter completion date.

Method of Acquisition (competitive or noncompetitive): AO click here to enter method of acquisition.

Nature of Award (initial or follow-on): AO click here to enter nature of award.

Nature of the Contractual Effort or Items Purchased: AO click here to enter brief description.

Please provide a brief description of the services/supplies provided under the contract administered by your organization: AO click here to enter brief description.

PART III – QUESTIONNAIRE INSTRUCTIONS

This questionnaire covers the topics that are in line with the Contractor Performance Assessment Reporting System (CPARS). This questionnaire is designed to provide basic information regarding the Contractor’s present/past performance results on the contracts they have been awarded with your company and your satisfaction with their performance. Controlled by: DLA Distribution CUI Category: PROCURE, SSEL Distribution/Semination Control: FED ONLY POC: Mogen Gilson, Phone 717-770-4757

AOs PLEASE NOTE: Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a lower than Satisfactory rating solely for not performing beyond the requirement of the contract.

Please use the following guide in preparing your response to the questions in Part IV:

Exceptional Definition: Performance meets contractual requirements and exceeds many to the Government’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 were highly effective.

Note: To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. 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.

Very Good Definition: Performance meets contractual requirements and exceeds some to the Government’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 was effective.

Note: To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been NO significant weaknesses identified.

Satisfactory Definition: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified.

Marginal Definition: 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.

Note: To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

Unsatisfactory Definition: 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.

Note: To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

Not Applicable Definition: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

PART IV - PERFORMANCE ASSESSMENT

For questions 1-8, please click on the drop down box and choose an item to rate the contractor for each question based upon the following scale:

In addition, please provide a justification for rating given if above or below satisfactory.

1. QUALITY OF PRODUCT OR SERVICE: AO choose a rating.

Justification for Rating: AO click here to enter justification.

2. TIMELINESS OF PERFORMANCE/SCHEDULE: AO choose a rating.

Justification for Rating: AO click here to enter justification.

3. COST CONTROL: AO choose a rating.

Justification for Rating: AO click here to enter justification.

4. GOOD BUSINESS RELATIONS: AO choose a rating.

Justification for Rating: AO click here to enter justification.

5. MANAGEMENT OF KEY PERSONNEL: AO choose a rating.

Justification for Rating: AO click here to enter justification.

6. UTILIZATION OF SMALL BUSINESS: (ONLY APPLICABLE TO LARGE BUSINESS CONTRACTORS) AO choose a rating.

Justification for Rating: AO click here to enter justification.

7. REGULATORY COMPLIANCE: AO choose a rating.

Justification for Rating: AO click here to enter justification.

8. ANY ADDITIONAL PERTINENT INFORMATION (i.e., SAFETY, SECURITY, ENVIRONMENTAL COMPLIANCE, MAINTENANCE OF GFE, etc.): AO choose a rating.

Justification for Rating: AO click here to enter justification.

For questions 9-18, please click on the drop down box and choose an item to select your response to each question based on the following scale:

In addition, please provide an explanation when necessary.

9. MEETS MOST ACCEPTABLE PERFORMANCE LEVELS (APLs) AND/OR CONTRACT QUALITY STANDARDS: Choose an item.

If no, please explain: Click here to enter explanation.

10. RESPONDS TO COMPLAINTS IN A TIMELY MANNER: Choose an item.

If no, please explain: Click here to enter explanation.

11. DISPUTES THE SCOPE OF THE REQUIREMENT: Choose an item.

If yes, please explain: Click here to enter explanation.

12. SUBMITS REASONABLE PRICE PROPOSALS ON CONTRACT CHANGES: Choose an item.

If no, please explain: Click here to enter explanation.

13. HAS PROBLEMS WITH PAYROLL, PAYING FOR SUPPLIES, OR SUBCONTRACTORS: Choose an item.

If yes, please explain: Click here to enter explanation.

14. DIFFICULT WHEN NEGOTIATING CHANGES: Choose an item.

If yes, please explain: Click here to enter explanation.

15. PRO-ACTIVELY ANTICIPATES, AVOIDS, OR MITIGATES PROBLEMS: Choose an item.

If no, please explain: Click here to enter explanation.

16. BILLING IS TIMELY, ACCURATE, AND COMPLETE: Choose an item.

If no, please explain: Click here to enter explanation.

17. IF GIVEN A CHOICE, WOULD YOU AWARD TO THIS CONTRACTOR AGAIN: Choose an item.

If no, please explain: Click here to enter explanation.

18. IS THERE ANY ADDITIONAL INFORMATION REGARDING THIS CONTRACTOR’S PERFORMANCE: Choose an item.

If yes, please explain: Click here to enter explanation.

PART V – RATER/EVALUATOR/ASSESSING OFFICIAL’S (AO) INFORMATION

Name: AO click here to enter name.

Title: AO click here to enter title.

Telephone Number: AO click here to enter telephone number.

Agency or Business: AO click here to enter agency/business.

Agency of Business Address: AO click here to enter agency/business address.

Signature: _________________________________________________________________________________ NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104 & CONTROLLED UNCLASSIFIED INFORMATION (CUI)

Various Construction/Building Related Efforts SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

CUI