Attachment 5 - Past Performance Questionnaire.pdf

EXCEPTIONAL

MARGINAL

2. SUBCONTRACTOR/CONSULTANT TO

NRLINST 4200.15

INSTRUCTIONS: The Naval Research Laboratory (NRL) requests that you complete this questionnaire and provide your feedback to assist with establishing the performance history for the Contractor identified below. In an effort to expedite receipt of the requested information, please do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to: no later than Eastern Standard Time, on

I. CONTRACTOR IDENTIFICATION

PAST PERFORMANCE QUESTIONNAIRE

1. CONTRACTOR NAME

3. CONTRACT NUMBER

5. PERIOD OF PERFORMANCE

8. DESCRIPTION OF EFFORT (Use additional sheets as needed)

7. CURRENT CONTRACT COST/PRICE6. INITIAL CONTRACT COST/PRICE

4. CONTRACT TYPE

HQ-NRL 4335/2 (6-14)(Front) SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104 -- FOR OFFICIAL USE ONLY

II. RATINGS

RATING

UNSATISFACTORY

SATISFACTORY

VERY GOOD

DEFINITION

Performance meets contractual requirements and exceeds many to the Government's benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

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

Performance barely meets some of the contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

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

Performance meets contractual requirements and exceeds some to the Government's benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective

III. PERFORMANCE ASSESSMENT

A. TECHNICAL PERFORMANCE: What is your OVERALL assessment of the Contractor's ability to meet the technical requirements?

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

N/AUNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

TECHNICAL PERFORMANCE

PRODUCT ASSURANCE - Assess the Contractor's technical performance in the following areas:

N/AUNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

DESIGN

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

DOCUMENTATION

TRAINING

TESTING

SOFTWARE DEVELOPMENT

INTEGRATION

FABRICATION

B. SCHEDULE PERFORMANCE: Rate the Contractor's ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

N/AUNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

SCHEDULE PERFORMANCE

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

N/A

D. MANAGEMENT PERFORMANCE: What is your OVERALL assessment of the Contractor's management performance?

UNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

MANAGEMENT PERFORMANCE

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

N/AUNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

COST PERFORMANCE

ADHERENCE TO THE ORIGINAL

COST ESTIMATE TARGETS?

DID THE CONTRACTOR CONTROL

SUBCONTRACTING COST?

DID THE CONTRACTOR OVERRUN

THE CONTRACT?

DID THE CONTRACTOR UNDERRUN

THE CONTRACT?

C. COST CONTROL: Rate the Contractor's effectiveness in forecasting, managing, and controlling cost and provide reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes)

YES NO YES NOYES NOYES NO

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

N/A

ASSESS THE CONTRACTOR'S MANAGEMENT PERFORMANCE IN THE FOLLOWING AREAS:

UNSATISFACTORYMARGINALSATISFACTORYVERY GOODEXCEPTIONAL

RESPONSIVENESS - Timeliness, completeness, and quality of problem identification.

QUALITY - Ability to provide a product or service that met your required level of quality.

SOCIOECONOMIC GOALS - Ability to meet any applicable subcontracting goals for utilization of Small Business (SB), Small Disadvantaged Business (SDB), Women-Owned Small Businesses (WOSB), Service- Disabled Veteran-Owned Small Business (SDVOSB), HUBZone and Historically Black Colleges and Universities/Minority Institutions (HBCU/MI).

PROGRAM MANAGEMENT - Effectiveness of integration and coordination of all activities required to execute.

SUBCONTRACT MANAGEMENT - Timely award and management of subcontractors..

SUBCONTRACT MANAGEMENT - Ability to meet the goals of the subcontracting plan, to include timely award and management.

MANAGEMENT OF KEY PERSONNEL - Performance in selecting, supporting and replacing - when necessary -key personnel.

COMMENTS (Rationale must be provided for ratings of EXCEPTIONAL or UNSATISFACTORY) (Use additional sheets as needed)

E. TERMINATION HISTORY:

HQ-NRL 4335/2 (6-14)(Back) SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104 -- FOR OFFICIAL USE ONLY

PREPARED BY

COMMENTS (Use additional sheets as needed)

F. RECOMMENDATION: Would you recommend selection of this company for future awards? Explain.

NAME/TITLE

SIGNATURE DATE SIGNED

ORGANIZATION E-MAIL ADDRESS

PHONE

CONVENIENCE

YES, I WOULD RECOMMEND THIS CONTRACTOR FOR

FUTURE AWARDS.

N/ADEFAULT

NO, I WOULD NOT RECOMMEND THIS CONTRACTOR

FOR FUTURE AWARDS.

(ext.)