Attachment 26 - Past Performance Information Sheet.pdf

ATTACHMENT 04

PAST PERFORMANCE INFORMATION SHEET

CONTRACT INFORMATION

CAGE Code:

1. Contractor Information Firm Name:

Address:

Phone Number:

Email Address:

Point of Contact:

Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain) Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

4. Project Description:

Complexity of Work High Med Routine

CUSTOMER INFORMATION

5. Customer Information Name:

Title:

Phone Number:

Email Address:

7. Date Questionnaire was completed (mm/dd/yy):

8. Customer’s Signature:

NOTE: CUSTOMER COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO THE GOVERNMENT CONTRACT REPRESENTATIVE WITH THEIR PROPOSAL. THE

GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

6. Describe the customer’s role in the project:

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

(SC)

Substantial Confidence

Based on the Offeror’s recent/relevant performance record, this customer has a high expectation that the Offeror will successfully perform the required effort for us again.

Based on the Offeror's recent/relevant performance record, the Government has a High Expectation that the Offeror will successfully perform the required effort.

(SAT)

Satisfactory Confidence

Based on the Offeror’s recent/relevant performance record, this customer has a reasonable expectation that the Offeror will successfully perform the required effort for us again.

Based on the Offeror's recent/relevant performance record, the Government has a Reasonable Expectation that the Offeror will successfully perform the required effort.

(UC)

Neutral Confidence

No recent/relevant performance record is available or the Offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

No recent/relevant performance record is available, or the Offeror's performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned. The Offeror may not be evaluated favorably or unfavorably on the factor of past performance.

(LC)

Limited Confidence

Based on the Offeror’s recent/relevant performance record, this customer has a low expectation that the Offeror will successfully perform the required effort for us again.

Based on the Offeror's recent/relevant performance record, the Government has a Low Expectation that the Offeror will successfully perform the required effort.

(NC)

No Confidence

Based on the Offeror’s recent/relevant performance record, this customer has no expectation that the Offeror will successfully perform the required effort for us again.

Based on the Offeror's recent/relevant performance record, the Government has No Expectation that the Offeror will be able to successfully perform the required effort.

(N/A) Not Applicable

No information or did not apply to your contract

Rating will be neither positive nor negative.

Contractor Information (Firm Name): ________________________________________________ Customer Information (Name): ________________________________________________________

TO BE COMPLETED BY CUSTOMER

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY

a) Quality of technical data/report preparation efforts SC SAT LC NC UC N/A

b) Ability to meet quality standards specified for technical performance

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

2. SCHEDULE/TIMELINESS OF PERFORMANCE

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below)

b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract

3. CUSTOMER SATISFACTION

a) To what extent were the end users satisfied with the project?

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes;

responsiveness to administrative reports, and communication)

c) Overall customer satisfaction

4. MANAGEMENT/PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force

b) Ability to hire, apply, and retain a qualified workforce to this effort

c) Government/Customer Property Control

d) Knowledge/expertise demonstrated by contractor personnel

e) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to changes

f) Effectiveness of overall management (including ability to effectively lead, manage and control the program)

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractually agreed price(s)

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Contractor Information (Firm Name): ________________________________________________ Customer Information (Name): ________________________________________________________

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns).

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

6. SAFETY/SECURITY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues?

b) Contractor complied with all security requirements for the project and personnel security requirements.

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

b) Compliance with contractual terms/provisions (explain if specific issues)

c) Would you hire or work with this firm again? (If no, please explain below)

d) In summary, provide an overall rating for the work performed by this contractor.

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

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