Attachment 6 - Past Performance Questionnaire Nov2022.pdf

Attachment 6

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Past Performance Questionnaire

PART ONE: INSTRUCTIONS

The company who has provided you with this form is proposing on a Department of Homeland Security (DHS) solicitation to provide support to operate, maintain and modify flight training devices to meet the mission needs of the U.S. Coast Guard. Past Performance is an extremely important part of the evaluation criteria for this acquisition, so your input is very important. The information is to be provided directly to, the US Coast Guard Contracting Officer. This information will not be disclosed to the Offeror. Please provide an honest assessment and return the questionnaire, by e-mail, to the e-mail address shown below, NLT 1200ET DECEMBER 31 2022. If you have questions regarding this questionnaire, please contact Contract Officer, Patricia Willett at Patricia.S.Willett@uscg.mil.

Completed questionnaires should be emailed to the following address:

Patricia.S.Willett@uscg.mill.

GENERAL INFORMATION

1. VENDOR’S NAME AND ADDRESS 2. CUSTOMER ORGANIZATION

3. CONTRACT NUMBER: 2a. EVALUATOR

4. CONTRACT VALUE: _______________________ NAME:

TITLE:

PHONE NO:

5. CONTRACT AWARD DATE: 6. CONTRACT COMPLETION DATE:

7. CONTRACT TYPE (Circle All That Apply): 8. COMPLEXITY OF WORK (Circle One):

Response):

Fixed Price Cost-Plus Fixed Price Cost-Plus Award Fee DIFFICULT ROUTINE

T & M OTHER ____________________

9. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

SOURCE SELECTION SENSITIVE INFORMATION

mailto:Patricia.S.Willett@uscg.mill