ATTACHMENT 3 PAST PERFORMANCE QUESTIONNAIRE.docx

ATTACHMENT 3:

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does [and/or notify the Contracting Officer]. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The Offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The Offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The Offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The Offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Substantial Confidence

· Satisfactory Confidence

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

D. Effectiveness in Forecasting and Controlling Estimated Costs

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

F. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

SAMPLE QUESTIONNAIRE COVER LETTER

LETTERHEAD

(Date)

FOR OFFICIAL USE ONLY

Mission and Installation Contracting Command (MICC)-Fort Eustis is in the process of selecting a Contractor for the Mission Command Training Program (MCTP).

One of the considerations in proposal evaluation is the verification of the Offerors' past and present performance on contracts, which reflect the Offeror's ability to perform on the proposed effort. We depend on information received from agencies such as yours, which have had firsthand experience with an Offeror, for the evaluation of the Offeror's performance on those contracts.

Our areas of interest in the Offeror are summarized in the enclosed questionnaire. As discussed in our initial phone contact with your office, our schedule is extremely tight and we need your written response no later than (NLT) _______ calendar days (Recommend incorporating the date the solicitation/RFP closes) after your receipt of this letter. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be emailed to Mr. Edward Wojtan (Contract Specialist) at edward.w.wojtan2.civ@army.mil. Please ensure the subject of the email is “MCTP Past Performance Questionnaire – In Support of Contractor Name.” Please direct questions to the same email address. Your completed questionnaire will become a part of the official Source Selection records.

Your help is greatly appreciated, and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.