ATTACHMENT 6 - Past Performance Questionnaires.pdf

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HULL PRESERVATION Federal contract opportunity
Solicitation number
N4523A22Q0550
Issued by
Department of the Navy Naval Supply Systems Command

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ATTACHMENT 6

PAST PERFORMANCE QUESTIONNAIRE

Instructions to Offeror: The Offeror shall complete PARTS I, II and III of this questionnaire. The Offeror shall then provide a copy of the partially completed questionnaire to the points of contact it identifies in

PART II a. and instruct them to complete PART IV of the questionnaire and forward the questionnaire, by the proposal due date, to:

Northwest Regional Maintenance Center

Attn: Mr. Gary Eaton (Email: gary.a.eaton1@navy.mil), or Mr. Alexander Stutzman (Email:

alexander.stutzman@navy.mil), NWRMC Code 423

2000 W Marine View Dr.

Everett, WA 98207

The government will only evaluate a past performance questionnaire if parts I, II, III and IV have been completed and submitted to the above address. All parts of the past performance questionnaire should be submitted to the address above by the proposal due date. Failure of the customer to submit the past performance questionnaire to the northwest regional maintenance center, as addressed above, within the requested timeframe may result in the inability of the government to evaluate that past performance questionnaire. In the event that a questionnaire is submitted after the source selection evaluation board (sseb) has completed its past performance valuation then that particular questionnaire will not be evaluated. All past performance information submitted by the offeror shall be provided to the government using the past performance questionnaire.

The Offeror may submit up to five (5) questionnaires. PARTS I, II, and III of any questionnaire shall not exceed three (3) pages.

PART I: Title of Past Performance Effort and Identification of Performing Activity

a. Assign a tracking number to this questionnaire; e.g. Number 1 of 5 questionnaires prepared.

b. Provide an Offeror point of contact and phone number for the administrative handling of this questionnaire.

c. Provide a contract number and short title that encompasses the work that was performed.

d. Provide the company name, address, zip code, technical and management points of contact, and phone number of the performing activity.

PART II: Customer Information

a. Provide the customer name, address, zip code and phone number for the following individuals:

Contracting Officer Name:

Program Manager Name:

b. Provide the Contract Number.

c. Identify the type of Contract.

d. Identify the Period of Performance.

e. Summarize the scope of work and the responsibilities of the Contractor.

f. Explain the status of the contract.

g. Explain the relevancy to hull preservation services.

h. Provide the DUNS number and CAGE code of the Offeror to enable the Government to conduct accurate searches in the PPIRS database.

PART III: Contractor’s Self‐Assessment

It is incumbent upon the Offeror to explain the relevance of the data provided to hull preservation services.

a. Explain the schedule performance (award date, the contractually required delivery date(s), the actual delivery date(s) and explanations for differences in actual and contractually required delivery dates).

b. Explain the technical performance (explain in detail any performance shortcomings or customer dissatisfaction, such as CPARS evaluations.)

c. Explain in detail any significant subcontracting/teaming required to successfully perform the contract.

PART IV: Customer Satisfaction

The following is to be completed by the offices of the cognizant Contracting Officer and Program

Manager. For the areas identified below, please use the following ratings as defined in FAR 42.153(h)(4):

a. 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 was highly effective.

b. 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 was effective.

c. 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.

d. 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.

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

f. Not Applicable (N/A): Please indicate if performance is Not Applicable in the comments section of each assessment elements.

Assessment Elements: Please select/circle the appropriate performance assessment value for each item on the questionnaire and provide supporting narrative.

a. Cost Control: Rate the contractor’s effectiveness in forecasting, managing, and controlling cost

(including reporting and analyzing variances) and ability to deliver at the agreed‐to cost/price.

Provide reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government‐imposed schedule changes).

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Comments:

b. Schedule: Rate the contractor’s ability to deliver according to the agreed‐to schedule. What were the causes of any schedule variances?

c. Technical Performance: Ability to overcome technical challenges by applying sound engineering principles, complete required engineering analyses, and develop adequate technical reports and plans.

d. Quality: Rate the contractor’s ability to provide a product or service that met your required level of quality. Assess the contractors conformance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards.)

e. Subcontract Management: Rate the contractor’s ability to meet the goals of the subcontracting plan, to include the ability to timely award and manage subcontracts. Please describe the offerors success in meeting planned goals and/or efforts made to overcome goal deficiencies and challenges as well as the offeror’s ability to successfully manage and integrate subcontractors.

f. Business Relations: Rate the contractor’s ability to integrate and coordinate all activities needed to execute the contract, specifically the timeliness, completeness, quality of problem resolution, corrective action plans, the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and ability to submit accurate invoices in a timely manner.

g. Management of Key Personnel: Assess the contractor’s performance in selecting, retaining, supporting, and replacing, ‐ when necessary – key personnel.

h. Evaluate conditional, provisional, or late delivery in which consideration was provided back to the Government.

i. Recommendation: To what extent would you recommend this contractor for additional contracts? Rate on the scale: 5 = Yes, definitely; 4 = Yes, likely; 3 = Maybe, 2 = No, not likely; 1 =

No, not ever; 0 = N/A.

5 4 3 2 1 0

Comments from: [ ] Contracting Office and [ ] Program Office

Reviewing Activity: _______________________________________________

Name/Title of reviewer: _______________________________________________

Phone number: _______________________________________________

Signature/Date: _______________________________________________

Concur by: _______________________________________________

Name/Title: _______________________________________________

Signature/Date: _______________________________________________

CUSTOMERS: PLEASE DO NOT PROVIDE COMPLETED QUESTIONNAIRES TO THE OFFEROR

File details come from the government source that posted it. Updated .