ATTACHMENT (2) PPQ - N4215821QS039.pdf

ATTACHMENT (2) SOLICITATION NUMBER: N4215821QS039

DEPARTMENT OF THE NAVY

Norfolk Naval Shipyard

PORTSMOUTH, VIRGINIA 23705

Past Performance Assessment Questionnaire

Source Selection Information – See FAR 2.101 and 3.104

Date:

Contractor/Offeror: __________________________________________________

Contract Number: _________________ Task Order Number: _________________________

Responding Agency/Company: _________________________________________________

The completion of this Past Performance Assessment Questionnaire is requested from the respondent’s agency/company in order that Norfolk Naval Shipyard (NNSY) may evaluate the aforementioned contractor’s past performance on previous contracts as it relates to the probability of successful accomplishment of the work required by NNSY relative to the award of the contract resulting from this solicitation.

It is requested that the Responding Agency/Company complete and email the Past Performance

Assessment Questionnaire NO LATER THAN JUNE 23, 2021 at 10:00am (EST) directly to the

Contract Specialist, Victoria Buela, by e-mail at victoria.buela@navy.mil. DO NOT return this form to the contractor being evaluated.

NOTE: IT IS THE RESPONSIBILITY OF THE OFFEROR TO ENSURE ALL PAST

PERFORMANCE QUESTIONNAIRES ARE SUBMITTED TO THE GOVERNMENT

BY THE CLOSING DATE AND TIME.

If you need more space than that provided, please attach additional pages. Responses will be treated as source selection sensitive information. If you have any questions, please contact the

Contracting Specialist at the above e-mail address.

Thank you for your quick response and assistance.

Source Selection Information – See FAR 2.101 and 3.104

1. Contract Information. Please complete the following for the contractor originating this request:

Contractor:

Contract Number:

Task Order Number:

Period of Performance:

Dollar Amount at Award:

Dollar Amount at Completion

(or Current Dollar Amount, if not Completed):

Contract Type: Fixed-Price;

Labor Hour or Time and

Material; Cost-

Reimbursement (CPFF, CPAF, CPIF, etc.)

Describe the Products and/or

Services that the

Contractor/Offeror performed for you under this referenced contract:

The number, type and severity of any quality, delivery or price problems in performing the contract, the corrective action taken and the effectiveness of the corrective action:

2. Performance Assessment Values.

5 - Exceptional. Performance meets contractual requirements and exceeds many requirements, to the Government’s benefit. Contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 – Very Good. Performance meets contractual requirements and exceeds some requirements, to the Government’s benefit. Contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 – Satisfactory. Performance meets contractual requirements. Contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

2 - Marginal. Performance barely meets some contractual requirements. Contractual performance of the element 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.

1 - Unsatisfactory. Performance does not meet some or most contractual requirements and recovery is not likely in a timely manner. Contractual performance of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

0 - Not Applicable. Unable to provide a score. Performance in this area not applicable to effort assessed.

3. Assessment Elements. Please select the appropriate performance assessment value for each item on the questionnaire and provide supporting narrative.

A. Cost Control. Rate the contractor’s effectiveness in forecasting, managing, and controlling cost (including reporting and analyzing variances) and ability to deliver at the agreed-to cost/price. Describe reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes).

5 4 3 2 1 0

Comments supporting assigned rating:

Source Selection Information – See FAR 2.101 and 3.104

B. Schedule. Rate the contractor’s ability to deliver according to the agreed-to schedule.

What were the causes of any schedule variances?

C. Quality/Meeting Contract Requirements.

1. Rate the contractor’s ability to provide a product or service that met or exceed the requirements of the contract. Identify contractor’s overall strengths and weaknesses.

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

3. Were there instances of rework and/or deficiency reports? 5 = Yes, definitely; 4 =

Yes, some; 3 = No, not likely; 2 = No, not ever; 1 = N/A.

5 4 3 2 1

4. Rate the contractor’s engagement in effective and/or innovative work applications that were beneficial to the Government?

5. Rate the contractor’s ability to provide a product or service that met your required level of quality. Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards.)

D. Subcontract Management.

1. Rate the contractor’s ability to meet the goals of the subcontracting plan, to include the ability to timely award and manage subcontracts.

E. Business Relations.

1. Rate the contractor’s ability to integrate and coordinate all activities needed to execute the contract, specifically the timeliness, completeness, quality of problem resolution and corrective action plans and the effectiveness of corrective actions take.

Source Selection Information – See FAR 2.101 and 3.104

2. Rate the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and its ability to submit accurate invoices in a timely manner.

F. Management of Key Personnel. Assess the contractor’s performance in selecting, retaining, supporting, and replacing—when necessary—key personnel.

G. Recommendation. To what extent would you recommend this contractor for additional contracts? Rate on the following scale: 5 = Yes, definitely; 4 = Yes, likely; 3 = Maybe, 2 = No, not likely; 1 = No, not ever; 0 = N/A.

4. Other References. If you are aware of any other contract or a Point of Contact (POC) who is familiar with the contractor’s performance under this contract, please identify.

Name, Phone, and E-Mail

Address:

5. Assessor Information. Please provide the following information about yourself:

Name:

Title:

Source Selection Information – See FAR 2.101 and 3.104

Address:

Phone Number:

E-Mail Address:

Thank you for your assistance.

Please return completed form to at victoria.buela@navy.mil NO LATER THAN JUNE 23, 2021 at 10:00am (EST). DO NOT return this form to the contractor being evaluated.

mailto:victoria.buela@navy.mil