Attachment 4. Past Performance Questionnaire.pdf

(WHEN COMPLETED)

CUI

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Present/Past Performance Questionnaire

SP330026Q0010

PART I – BACKGROUND

The RFQ has been issued to solicit offers that would provide the best value to the Government for the requirements of the procurement. The specific RFQ requirements may be referenced at www.sam.gov. The place of performance for this contract is DLA Distribution Albany, Georgia.

The contract will be for on-site Preventive Maintenance, Remedial Maintenance Support Services and Crane Rental Support Services. A company that is interested in providing an offer on the

RFQ has requested that your firm complete this present/past performance questionnaire and submit it to the following:

RETURN INFORMATION

Email completed questionnaire to the acquisition specialist: morgan.costanzo@dla.mil.

All questionnaires shall be sent to the acquisition specialist by the quote due date and time.

PART II – QUESTIONNAIRE INSTRUCTIONS

This questionnaire covers the topics that are in line with the Contractor Performance Assessment

Reporting System (CPARS). This questionnaire is designed to provide basic information regarding the Contractor’s present/past performance results on the contracts they have been awarded with your company and your satisfaction with their performance.

RATERS PLEASE NOTE: Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a lower than Satisfactory rating solely for not performing beyond the requirement of the contract.

Please use the following guide in preparing your response to the below questions:

Exceptional

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

Note: To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

Very Good

Definition: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

Note: To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.

Satisfactory

Definition: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

(WHEN COMPLETED)

http://www.fbo.gov/

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified.

Marginal

Definition: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

Unsatisfactory

Definition: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

Not Applicable

Definition: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

PART III - PERFORMANCE ASSESSMENT

Please CIRCLE your response below each question based on the following scale:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

In addition, please provide a justification for rating given if above or below satisfactory.

1. QUALITY OF PRODUCT OR SERVICE:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

2. TIMELINESS OF PERFORMANCE:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

3. COST CONTROL:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

4. GOOD BUSINESS RELATIONS:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

5. MANAGEMENT OF KEY PERSONNEL:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

6. UTILIZATION OF SMALL BUSINESS: (ONLY APPLICABLE TO LARGE BUSINESS

CONTRACTORS)

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

7. ANY ADDITIONAL PERTINENT INFORMATION, i.e., SAFETY, SECURITY, AND

ENVIRONMENTAL COMPLIANCE, MAINTENANCE OF GFE, etc.:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Justification for Rating:

Please CIRCLE your response below each question based on the following scale:

Yes No

In addition, please provide an explanation when necessary.

8. MEETS MOST ACCEPTABLE PERFORMANCE LEVELS (APLs) AND/OR

CONTRACT QUALITY STANDARDS:

Yes No

If no, please explain:

9. RESPONDS TO COMPLAINTS IN A TIMELY MANNER:

Yes No

If no, please explain:

10. DISPUTES THE SCOPE OF THE REQUIREMENT:

Yes No

If yes, please explain:

11. SUBMITS REASONABLE PRICE PROPOSALS ON CONTRACT CHANGES:

Yes No

If no, please explain:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

12. HAS PROBLEMS WITH PAYROLL, PAYING FOR SUPPLIES, OR

SUBCONTRACTORS:

Yes No

If yes, please explain:

13. DIFFICULT WHEN NEGOTIATING CHANGES:

Yes No

If yes, please explain:

14. PRO-ACTIVELY ANTICIPATES, AVOIDS, OR MITIGATES PROBLEMS:

Yes No

If no, please explain:

15. BILLING IS TIMELY, ACCURATE, AND COMPLETE:

Yes No

If no, please explain:

16. IF GIVEN A CHOICE, WOULD YOU AWARD TO THIS CONTRACTOR AGAIN:

Yes No

If no, please explain:

17. PLEASE PROVIDE ANY ADDITIONAL INFORMATION REGARDING THIS

CONTRACTOR’S PERFORMANCE, IF APPLICABLE:

PART IV - GENERAL PROGRAM INFORMATION

RELEVANT PREVIOUS CONTRACT -- IDENTIFICATION

Please provide a brief description of the services/supplies provided under the contract administered by your organization:

Contract Original Dollar Amount: ____________________

Contract Current Dollar Amount: ____________________

Contract Original Period of Performance: ______________

Contract Current Period of Performance: ______________

Contractor/Company Name/Division: ____________________

Contract Place of Performance (Address): ____________________

Program Identification/Title: ____________________

Contract Number: ____________________

Contract Type: ____________________

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Prime Contractor Name (if this was a subcontract effort): ____________________

Contract Award Date: ____________________

Forecasted or Actual Contract Completion Date: ____________________

Method of Acquisition (competitive or noncompetitive): ____________________

Nature of Award (initial or follow-on): ____________________

Nature of the Contractual Effort or Items Purchased: ____________________

Evaluator’s Name: _____________________Evaluator’s Signature: ________________________

Evaluator’s Title: ___________________Evaluator’s Telephone Number: ___________________

Agency or Business: ______________________________________________________________

Address:

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SOURCE

SELECTION SENSITIVE INFORMATION IAW FAR 3.104.