Attachment 2 - Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Solicitation 140D0420R0013

R&D: Secure Hybrid Composite Container

NOTICE: ONCE COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SENSITIVE AND SHALL NOT BE

RELEASED TO THE OFFEROR.

SECTION 1: CONTRACT IDENTIFICATION

(to be completed prior to mailing or faxing to the respondent)

A. Contractor's Name:

i. Are you proposing as a prime under 140D0420R0013? Yes No , if no, who are you partnering with?_

B. Contract number for Past Performance Ref:

C. Contractor's Role in the contract identified above: Prime: Yes No Subcontractor to Prime? If Yes, who?

D. Cage Code:

E. Contract type:

F. Was this a competitive contract? Yes No G. Period of performance:

H. Initial contract cost: $_ I. Current/final contract cost: $ J. Reasons for differences between initial contract cost and final contract costs:

K. Description of research/service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

(to be completed prior to mailing or faxing to the respondent)

A. Customer or agency name:

B. Customer or agency description (if applicable):

SECTION 3: EVALUATOR IDENTIFICATION

(to be completed by the respondent)

A. Evaluator's name:

B. Evaluator's title/role:

C. Evaluator's phone/fax number:

D. Number of years evaluator worked on subject contract:

SECTION 4: EVALUATION

(to be completed by the offeror)

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: 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.

Technical Performance E V S M U N/A Technical competencies in producing composite structures capable of being used in the construction ISO 668 maritime containers.

Technical competencies in composite materials selection optimizing the production of a composite container.

Technical competencies in the design of intrusion security through walls/structures with focus on composite walls.

Technical competencies in easily integrating intrusion security in composite container walls.

Technical competencies in supplying power to low power sensors and communications capabilities.

1. Please discuss each and every response for which you indicated a M (Marginal) or US (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

2. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes No

Default Convenience Pending Terminations

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs? Yes or No (Circle One)

Please provide any additional comments concerning this contractor’s performance in a separate document.

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

RETURN YOUR COMPLETED QUESTIONNAIRE VIA EMAIL TO:

nina_leshock@ibc.doi.gov and kevin_woody@ibc.doi.gov mailto:nina_leshock@ibc.doi.gov mailto:nina_leshock@ibc.doi.gov mailto:carrie.nelson@socom.mil mailto:carrie.nelson@socom.mil