Attachment 4A Past Performance Reference W9127Q-22-R-0007.pdf

ATTACHMENT 4A - PAST PERFORMANCE REFERENCE QUESTIONAIRE

MS NG EMPLOYMENT OUTREACH SERVICES

W9127Q-22-R-0007– WORK FOR WARRIORS

ATTACHMENT 4A

PAST PERFORMANCE REFERENCE QUESTIONNAIRE

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and submit to the owners of the projects listed in your Attachment 4, “Performance Relevancy Questionnaires”, a Past Performance Reference Questionnaire (Attachment 4A).

Prepare a minimum of three (3), not more than five (5) Questionnaires packages. For Government contracts, send to the Contracting Officer at their local contracting office. For commercial references, send to personnel with duties similar to those for Government contracts.

Offerors should follow-up and encourage references to return completed questionnaires in a timely manner. Questionnaires are due to the USPFO Contracting Office no later than one day prior to the solicitation close date/due date. If you have multiple references at one location (i.e. at a military base), send one cover letter and questionnaires for each contract for which you need a reference. Your questionnaire package should contain the following:

• Cover Letter (See SAMPLE on the next page)

• Respondent Info Rating Sheets (the following 4 pages). As the Offeror, you complete Blocks 1-4 before sending the same to your reference.

Your reference completes Blocks 5-8 and answers the Questionnaire.

• Be sure your Clients understand to email completed questionnaire to the Government at the email address provided. Questionnaires are not to be returned to the Offeror.

In accordance with Attachment 3 Evaluation Criteria and Basis for Award, completed questionnaires should be sent directly to the Contracting Office.

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE

SENDING OUT QUESTIONNAIRE. AFTER RESPONSES /

REVISIONS,

ALL RED LETTERING IN DOCUMENTS BELOW MUST BE REMOVED/DELETED.

Your Company Letterhead

(Date)

To: Your Client’s company name

& POC for this survey

SUBJECT: PAST PERFORMANCE EVALUATION QUESTIONNAIRE

for Employment Outreach Services for MS ARNG

Dear (POC’s Name)

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm will be submitting a proposal under a project advertised by the USPFO of Mississippi, Purchasing and Contracting Office. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the government evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Only one response from each office is required. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses.

Complete confidentiality will be maintained. Only one response from each firm is required.

Please do not return questionnaire to us, return your completed questionnaire to the Government at the following email addresses:

davis.c.scott2.civ@army.mil; lisa.d.anguizola.civ@army.mil

The Government must receive your Questionnaire NOT LATER THAN Thursday, 25 August 2022 2:00 PM CST, so that it can be included in the evaluation of our proposal.

If you have questions regarding the attached questionnaire, or require assistance, please contact the USPFO Contracting Officer via email at the address provided above. Thank you for your assistance.

Sincerely, Your Signature, Typed Name and Title mailto:davis.c.scott2.civ@army.mil

National Guard PAST PERFORMANCE QUESTIONNAIRE (Attachment 4A)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information Firm Name: CAGE Code:

Address: UEI Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other

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):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work High Med Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name:

Title:

Phone Number:

Email Address:

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

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

8. Client’s Signature:

NOTE: THE NATIONAL GUARD REQUESTS THAT THE CLIENT COMPLETE THIS QUESTIONNAIRE AND

SUBMITS DIRECTLY TO GOVERNMENT. EMAIL COMPLETED SURVEY TO davis.c.scott2.civ@army.mil and lisa.d.anguizola.civ@army.mil THE GOVERNMENT RESERVES THE RIGHT

TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

mailto:lisa.d.anguizola.civ@army.mil

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/Owner’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 was highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. 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.

(VG) Very Good Performance meets contractual requirements and exceeds some to the Government’s/Owner’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.

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the

Government/Owner. There should have been no significant weaknesses identified.

(S) Satisfactory Performance meets minimum 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.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) 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.

A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the

Government/Owner.

(U)

Unsatisfactory 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 serious problem(s) for which the contractor's corrective actions appear or were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the

Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

(N) Not

Applicable

No information or did not apply to your contract

Rating will be neither positive nor negative.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR

EVALUATION OF THE CONTRACTOR’S PERFORMANCE

TO BE COMPLETED BY CLIENT

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 E VG S M U N

b) Ability to meet quality standards specified for technical performance

E

VG

S

M

U

N

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. CUSTOMER SATISFACTION:

a) To what extent were the end users satisfied with the project? E VG S M U N

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

responsiveness to administrative reports, businesslike and communication)

c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? E VG S M U N

d) Overall customer satisfaction E VG S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of labor force?

E VG S M U N

b) Ability to hire, apply, and retain a qualified workforce to this effort E VG S M U N

c) Government Property Control E VG S M U N

d) Knowledge/expertise demonstrated by contractor personnel E VG S M U N

e) Utilization of Small Business concerns E VG S M U N

f) Ability to simultaneously manage multiple tasks and pending deadlines?

E VG S M U N

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

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

E VG S M U N

5. COST/FINANCIAL MANAGEMENT

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

E VG S M U N

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

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.

Yes

No

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

7. GENERAL

a) Ability to successfully respond to emergency and/or urgent 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)

E VG S M U N

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.

E VG S M U N

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

(attach additional pages if necessary)

NOTE: The National Guard requests that the Client complete this questionnaire and submit response directly to the Government, not to the Offeror that requested this questionnaire. Email completed questionnaire to davis.c.scott2.civ@army.mil and lisa.d.anguizola.civ@army.mil The Government reserves the right to verify any and all information on this form.

mailto:lisa.d.anguizola.civ@army.mil