Attachment 2_PAST_PERFORMANCE_REPORT_FORM.pdf

Source Selection Information – See FAR 2.101 and 3.104

PAST PERFORMANCE REPORT FORM

Solicitation N0018921Q0015

Complete and return NLT DUE DATE OF SOLICITATION to:

Fleet Logistics Center Norfolk (FLCN)

Contracting Department, Attn: Amy Barnes, Code 240.1

Phone: (757) 443-1326

Email: amy.m.barnes1@navy.mil

On behalf of:

Company's Name: _________________________________

POC/Title/Position: _________________________________

Email Address: _________________________________

Contract/Purchase Order No.: _________________________________

Contract Amount: _________________________________

Contract Type: _________________________________

Period of Performance: _________________________________

Business Address: _________________________________

Phone Number: _________________________________

NOTE: DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS

REQUEST

The completion of this questionnaire is requested from your agency/company in order for the

U.S. Naval Supply System (NAVSUP) Fleet Logistics Center Norfolk (FLCN) to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract.

Completed by :

Command/Company’s Name: _________________________________

POC/Title/Position: _________________________________

Email Address: _________________________________

Address: _________________________________

Phone Number: _________________________________

PAST PERFORMANCE QUALITY QUESTIONNAIRE

Quality:

1. Recruiting: How would you describe offeror’s demonstrated ability to recruit personnel with the skill sets, qualifications/certifications, experience and security clearance required of the contract. Provide additional comments if necessary.

2. Retention: Describe the offeror’s demonstrated ability to maintain a stable workforce.

3. Quality/Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.

a. How would you describe your level of customer satisfaction?

b. Were there instances of rework and/or deficiency reports? (If yes, explain)

c. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?

4. Quality/Timeliness.

a. Did the Contractor meet/comply with performance schedules?

b. Rate the timeliness of submission of requested information, reports and invoicing.

5. Quality/Contractor Responsiveness. The offeror’s demonstrated ability to:

a. respond to customer concerns

b. isolate and resolve problems the number and severity of problems the effectiveness of corrective actions taken.

c. Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/under-run, Government-imposed schedule changes, etc.)

6. Additional Observations/Information

a. Identify the contractor's overall strengths and weaknesses.

b. Given hindsight, are you satisfied that the contract was awarded to this contractor?

Would you be pleased to have this contractor perform work for you again? Why?

c. Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

d. Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.