Attachment H - PICS STENS Past Performance Questionnaire_20220727.docx
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- Solicitation number
- DRAFT_RFP_70RSAT22R00000022
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APPENDIX C - Past Performance Questionnaire
PART ONE: INSTRUCTIONS
The company that has provided you with this form (“the offeror”) is proposing on a Department of Homeland Security (DHS) solicitation to provide a range of scientific, technical and engineering services for facility decontamination and decommissioning to meet the mission needs of DHS. 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 DHS Contract Specialist. This information will not be disclosed to the offeror. Please provide an honest assessment and return the questionnaire to DHS, by e-mail, to the address shown below, no later than the time and date the solicitation closes XXXXXXX_. If you have questions, please contact Mr. Robert Marosz, Contract Specialist (robert.marosz@hq.dhs.gov). Completed questionnaires should be emailed to the following address: robert.marosz@hq.dhs.gov
PART TWO: GENERAL INFORMATION
| 1. OFFEROR’S NAME AND ADDRESS | 2. CUSTOMER ORGANIZATION |
| ___________________________________ | ____________________________________ |
| ___________________________________ | ____________________________________ |
| ___________________________________ | ____________________________________ |
| ___________________________________ | ____________________________________ |
| ___________________________________ | ____________________________________ |
| 3. CONTRACT NUMBER: ___________ | 2a. CUSTOMER POINT OF CONTACT | |||
| 4. CONTRACT VALUE:_____________ | NAME:_____________________________ | |||
| TITLE:_____________________________ | ||||
| PHONE NO:________________________ | ||||
| 5. CONTRACT AWARD DATE: | 6. CONTRACT COMPLETION DATE: | |||
| _____/____/______ | _____/____/______ |
7. CONTRACT TYPE
(Circle/Underline All That Apply).
Fixed Price Cost-Plus Fixed Price Cost-Plus Award Fee T&M Other
PART TWO: GENERAL INFORMATION CONTINUED
8. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS: (Please Add Additional Pages if Needed)
PART THREE: OFFEROR PERFORMANCE RATING
On the following pages, please summarize the offeror’s performance in each rating factor. Each Factor has four possible adjectival ratings. Determine the adjectival rating that most nearly represents your experience with this offeror and indicate your assessment by placing an “X” under the appropriate heading. Offeror performance factors are:
· Facility Decontamination – Scientific Services
· Integration of Engineering/Logistical Services
· Management Approach
Adjectival ratings are defined below and should be used as a reference in assessing performance:
NEUTRAL No relevant performance record is identifiable upon which to base a meaningful performance rating. A search was unable to identify any relevant past performance information for the offeror, Key Personnel, or subcontractors. This is neither a negative nor a positive assessment.
SUPERIOR Based on the offeror’s past performance record, it is highly likely that the offeror will successfully perform the required effort.
SATISFACTORY Based on the offeror’s past performance record, it is likely that the offeror will successfully perform the required effort.
UNSATISFACTORY Based on the offeror’s past performance record, it is not likely that the offeror will successfully perform the required effort.
| Facility Decontamination – Scientific Services |
| Neutral |
| Superior |
| Satisfactory |
| Unsatisf. |
| 1 |
| Was the contractor effective in developing and executing scientific activities as part of this contract? |
| 2 |
| If applicable, did the contractor integrate scientific performance with other performers (federal, other contractors, etc.)? |
| 3 |
| If applicable, as part of scientific services, was the contractor successful in translating results into application through this contract? |
| 4 |
| Was the contractor able to successfully conceive and develop outward-facing materials, i.e., presentations, manuscripts, other contributions to industry practice? |
| 5 |
| Was the contractor effective in developing and executing sampling methodologies? |
Please provide commentary to substantiate your performance factor ratings in the space below. Please add additional pages as necessary.
| Integration of Engineering/Logistical Services |
| Neutral |
| Superior |
| Satisfactory |
| Unsatisf. |
| 1 |
| Was the contractor effective in planning and performing engineering and related (e.g., logistical) services during this contract? |
| 2 |
| If applicable, did the contractor integrate engineering performance with other performers (federal, other contractor, etc.)? |
| 3 |
| If applicable, did the contractor execute and/or manage third party verification activities, such as independent laboratory review of samples? |
| 4 |
| Was the contractor effective in developing and executing validation methodologies (e.g., biological or chemical indicators) for the decontamination process? |
Please provide commentary to substantiate your performance factor ratings in the space below. Please add additional pages as necessary.
| Management Approach |
| Neutral |
| Superior |
| Satisfactory |
| Unsatisf. |
| 1 |
| Did the contractor provide effective contract and project management? |
| 2 |
| Did the contractor supply professional and appropriately qualified personnel? |
| 3 |
| Did the contractor effectively integrate tasks representing different disciplines, e.g., scientific, engineering, logistical? |
| 4 |
| Did the contractor effectively manage applicable regulatory aspects, i.e., interaction, compliance? |
| 5 |
| Did the contractor effectively manage risk as part of this project? |
Please provide commentary to substantiate your performance factor ratings in the space below. Please add additional pages as necessary.
1. What were the contractor’s greatest strengths in the performance of the contract?
2. What were the contractor’s greatest weaknesses in the performance of the contract?
3. Did the contractor achieve its small business sub-contracting plan goals, and if not did they provide acceptable documentation of their good faith effort to do so?
4. Would you award another contract to this contractor? YES________ NO________
Please provide any additional comments that you feel would assist DHS in its evaluation of this performer’s past performance.
SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104
SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 Page 23
PICS STENS RFP 70RSAT22R00000022
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