ATTACHMENT 4B Past Performance Questionnaire 20220304.pdf

ATTACHMENT #4B Page 1 of 4

PAST PERFORMANCE QUESTIONNAIRE

Solicitation #: W9127Q-22-R-0002, Special Operations Combatives Program Technical Instructional Services RCTA-MS

Your assistance is requested in support of a Source Selection. IMPORTANT: Offeror MUST NOT review the completed Past Performance Questionnaire (PPQ) before submission. All completed PPQs must be submitted by the reference directly to the USPFO-MS Contracting Office via email, fax, or mail (email preferred) NLT Friday, March 25, 2022 @ 2:00

PM CST:

Mississippi Army National Guard Office of the U.S. Property & Fiscal Officer for MS Flowood, MS, 39232

ATTN: Mr. Davis Scott, Contract Specialist Email: davis.c.scott2.civ@army.mil

When completed, the information on this form becomes SOURCE SELECTION SENSITIVE INFORMATION

(41 U.S.C. 423) and shall be protected, accordingly.

PART 1 TO BE COMPLETED BY OFFEROR SUBMITTING PROPOSAL

1. Offeror Name & Complete Address: Offeror must complete blocks 2 -7 to identify the contract between the offeror and the evaluating organization. NOTE:

contract must be relevant (similar scope, complexity, target audience) to the RFP.

2. Contract No:

3. Contract Initiation Date:

4. Contract Completion Date:

5. Contract Value (including options): $

6. Type of Contract (i.e., Firm-Fixed Price (FFP), Cost, Time & Material):

7. Description of Service(s)/Course(s) provided under referenced contract. (Include enough detail to determine relevance to requested training. Please add a continuation sheet if more space is required):

PART 2 TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION:

a) Evaluator’s Name, Position:

b) Evaluator’s Phone #:

c) Evaluator’s Email:

d) Duration of Business Relationship with Offeror’s Firm:

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Please select the response code which best reflects your experience with this contractor.

EX = Exceptional – Performance meets contractual requirements and exceeds many. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG = Very Good - Performance meets contractual requirements and exceeds some. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S = Satisfactory - Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MG = Marginal - Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

US = Unsatisfactory - Performance does not meet most contractual requirements and recovery is not likely in a timely manner.

The element being assessed contains serious problem(s) for which the contractor’ corrective actions appear or were ineffective.

N/O = Not Observed – Performance in this element or sub-element was not observed.

(Please provide narrative comments below each factor to identify specific strengths/weakness relative to that factor.)

A. Quality of Product/Service

Course Design & Development EX VG S MG US N/O

Course Curriculum / Agenda EX VG S MG US N/O

Quality of Instruction EX VG S MG US N/O

Course Materials / Handouts EX VG S MG US N/O

Course Benefit in Workplace EX VG S MG US N/O

B. Schedule

Adherence to Schedule EX VG S MG US N/O

Flexibility in Scheduling EX VG S MG US N/O

C. Business Relationship

Business/Contracting Relationship EX VG S MG US N/O

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Problem Resolution EX VG S MG US N/O

Process Improvement EX VG S MG US N/O

Lesson Learned Incorporation EX VG S MG US N/O

Cooperative Behavior EX VG S MG US N/O

Commitment to Customer Satisfaction

EX VG S MG US N/O

Responsiveness EX VG S MG US N/O

D. Management of Key Personnel (Instructors)

Technical Knowledge in Course Subject Matter

Thoroughness EX VG S MG US N/O

Accuracy EX VG S MG US N/O

E. Overall Assessment of Contractor

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9. For any elements identified above that were rated Marginal or Unsatisfactory, has unsatisfactory performance been shared with the contractor?

( ) Yes ( ) No If Yes, communications with the contractor were ( ) written / ( ) verbal.

10. PLEASE PROVIDE NARRATIVE COMMENTS TO IDENTIFY (please add continuation page for additional comments):

a) Two or three of the offeror’s best business traits or observed skills.

b) Areas where the offeror has room for improvement.