Attachment 3 - Past Performance Report Form.pdf

PAST PERFORMANCE REPORT FORM

Complete and return NLT 11:00 AM ET on 16 January 2025 to:

NAVSUP Fleet Logistics Center Norfolk (FLCN) Contracting Department, Attn: Justin Hall and Benjamin Fisher - Code 214.2 Phone: Hall (757) 550-0894, Fisher (717) 298-7199 Email: justin.d.hall12.civ@us.navy.mil; benjamin.d.fisher8.civ@us.navy.mil

On behalf of (Requester Information):

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: _________________________________

1. 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?

mailto:justin.d.hall12.civ@us.navy.mil mailto:benjamin.d.fisher8.civ@us.navy.mil

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?

2. Quality/Timeliness.

a. Describe the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

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

3. 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.)

4. 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.

(If more comment space needed, please attach additional pages.)