Attachment 4 Past Performance Survey.doc

CONTRACTOR PAST PERFORMANCE DATA SHEET

Offeror’s Name: ________________________________

The questionnaire shall be completed as provided. If required, only the spacing may be modified to accommodate the Offeror or respondent’s comments.

Part I – To be completed by Quoter and Forwarded to Commercial or Government Respondent

Contract number:

Point of contact/phone number, email, and fax number at agency or corporation where the contract was performed: _________________________________________________________________________ Detailed description of the work performed:

Dollar value of contract:

Name(s) of subcontractors used, if any, and a description or work performed by the subcontract(s):

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 correction action:

Part II – To be completed by the Respondent and returned to DLA Disposition Services (Please do not return to the Contractor who originated this request) A. The completion of Part II of this questionnaire is requested from your agency/company in order for the DLA Disposition Services to evaluate the aforementioned contractor’s past performance on previous contracts as it relates to the probability of successful accomplishment of the work required by the Government relative to the award of the contract resulting from the solicitation.

Please provide concise comments regarding your overall assessment of the contractor’s performance on the contract identified below. Please respond to each question in a narrative format. Please email or fax your completed questionnaire along with a copy of Part I directly to:

Please submit this response by solicitation closing date.

Company's Name:

POC/Title/Position:

Email Address:

Contract/Purchase Order No:

Contract Amount:

Contract Type:

Period of Performance:

Business Address:

Phone Number:

B. Explanation of codes:

Exceptional 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.

Very Good 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 were effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal 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.

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

C. Circle the appropriate letter for each item on the questionnaire and provide supporting narrative.

1. Rate the Offeror’s Technical Performance (Quality of Product/Service):

(i) Did the offeror's service comply with contract requirements?

E

VG

S

M

U

(ii) Were reports or other deliverables accurate and fully descriptive?

E

VG

S

M

U

(iii) Were there any performance problems, and if so were they resolved effectively?

E

VG

S

M

U

2. Rate the Offeror’s Management/Key Personnel (Management):

(i) Were adequate Key Personnel allocated to meet the contract requirements and if necessary, were Key Personnel replaced effectively?

E

VG

S

M

U

(ii) Were Key Personnel able to respond to your concerns, isolate and resolve problems and take systemic improvement action?

E

VG

S

M

U

3. Rate the Offeror's Schedule Compliance/Timeliness:

(i) Demonstrated ability to comply with: delivery and/or performance schedules. What were the causes of any delay?

E

VG

S

M

U

(ii) Timeliness of submission of requested information, reports, and invoicing.

E

VG

S

M

U

4. Rate the Offeror's Small Business/Socioeconomic Interest Utilization, if applicable:

(i) Assess whether the Contractor provided maximum practicable opportunity for Small Business (including Alaska Native Corporations (ANCs) and Indian Tribes), Small Disadvantaged Businesses (which also includes ANCs and Indian Tribes), Women Owned Small Businesses, HUBZone, Veteran Owned, Service Disabled Veteran Owned Small Business, and ANCs and Indian Tribes (that are not Small Disadvantaged Businesses or Small Businesses) to participate, including compliance with corresponding contract terms as applicable (e.g. FAR 52.219-9 Small Business

Subcontracting Plan.

E

VG

S

M

U

5. Rate the Offeror's Compliance with Additional Regulatory Requirements if applicable:

(i) Assess the contractor’s compliance with additional regulatory considerations, such as but not limited to Environmental and/or Hazardous Waste Regulations, Bio-Based Product Utilization, and EEO Compliance (please note the applicable regulatory aspect(s) in the supporting narrative section after the rating):

E

VG

S

M

U

C. What is your overall rating of the contractor’s performance?

E

VG

S

M

U

D. Given the choice, would you award to this contractor again?

YES

NO