Attachment IV Past Performance Questionnaire with Cover Page.pdf

ATTACHMENT IV

SOLICITATION SPE603-20-R-0523

TYNDALL AFB, FLORIDA

CONTRACT PERFORMANCE ASSESSMENT FORM

GENERAL INFORMATION (Offeror to complete this portion)

Contractor Name (Name of Company or Organization)

Name of Point of Contact/Email Address Phone Number Original Contract Price

Name of Contractor Contract Number Period of Performance

Contract Dates Contract Type Worked Performed as: Complexity of Work

Award Date: __________________

Contract Comp. Date: __________

Actual Comp. Date: ___________

Firm Fixed Price Cost Reimbursement Other ________________

Prime Contractor Sub-Contractor Prime Name: ______________

Joint Venture

High Medium Low

Brief Description of work/supplies furnished to Customer

CLIENT INFORMATION (Reference to complete this portion)

Client Information

Name of Person Interviewed / Completing Questionnaire Title Email Address

Client’s Signature and Date

PLEASE RETURN THIS FORM WITH THE COMPLETED QUESTIONNAIRE TO:

(Contract Specialist: Jackie Robinson-Tiller, Jackie.Robinson@dla.mil, 571-767-9382)

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

FOR OFFICIAL USE ONLY

mailto:Selinda.Johnson@dla.mil

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

GENERAL GUIDANCE FOR COMPLETING QUESTIONNAIRE

A. The questionnaire should be completed by the individual most knowledgeable of the Contractor’s day-to-day operations and overall condition of the services being rendered. However, that individual is encouraged to supplement their own knowledge of the Contractor’s performance with the judgment of others in their organization, as applicable.

B. Handwritten responses are sufficient. However, request they be legible.

C. Please provide explanatory narratives for as many responses as possible. These narratives need not be lengthy, just descriptive. Space for narrative comments is included after each question and on the last page of the survey. If more space is needed, use the back of the survey or attach additional pages.

D. As the survey relates to an ongoing source selection for the services identified in the cover letter, request that all information provided within the survey be safeguarded against unauthorized disclosure.

E. The following description should be used as a guide in providing element ratings:

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 were highly effective.

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 were effective.

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.

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.

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

NOTE: The adjectival ratings Exceptional, Very Good, Satisfactory, Marginal, and Unsatisfactory reflect the ratings in the Contractor Performance Rating System (CPARS). However under the DOD’s streamlined process for evaluating Past Performance under Lowest Price Technically Acceptable, ratings of Acceptable and Unacceptable must be used. Therefore the Contracting Officer has determined that CPARS/Survey ratings of Exceptional, Very Good, Satisfactory, and Marginal will equate to an Acceptable rating. Rating of Unsatisfactory will equate to an Unacceptable rating.

Contractor Performance Assessment Input Form

Please assess the above contractor’s performance in the below areas. The narrative should include positive and negative statements to match the rating below each section.

1. Quality of Service: Assessment based on the contractor’s conformance to contract requirements, specifications and standards of good workmanship to include ability to accommodate change. (I.e. Did the contractor exhibit knowledge of/ and comply with Government (or other) regulations? Did the contractor demonstrate technical expertise in providing all contractual services? Did the contractor utilize personnel or possess tools/equipment necessary to adequately provide the services? Was a Show Cause or Cure Notice or Discrepancy Report ever been issued? Was the contract terminated for default? Did the contractor display the ability to correct problems? Did the contractor meet the standards for Technical Performance/Administrative Performance/Safety & Health.)

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

2. Schedule: Assessment based on the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements to include responding to any correspondences. (I.e. were tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract? Was contractor responsive to technical and/or contractual direction? Was he compliant with contract terms and conditions? Were there any contract concessions/changes/terminations made due to the contractor's failure to accurately plan?)

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

3. Cost Control: Assessment should be based on the contractor’s effectiveness in forecasting, managing, and controlling contract cost, employ adequate budgetary internal controls. If the contract is Firm-Fixed Price or Firm- Fixed Price with Economic Price Adjustment, please mark “Not Applicable”. (I.e. Did the contractor perform the effort within the estimated cost/price? Did contractor provide accurate and complete billings? Did the contractor submit accurate invoices on a timely basis? Demonstrate cost efficiencies in performing the required effort?)

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

4. Management of Key Personnel: Assessment based on the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel. (I.e. Is the contractor managing subcontractors in order to meet the requirements of the contract? Did the contractor train personnel? Was the labor turnover in key personnel labor categories minimal? Did it adversely affect/or not the contractor’s performance? Contractor did not frequently propose personnel to fulfill the requirements of the contract who were clearly unqualified.)

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

5. Small Business: (This area applies only to domestic contracts.) Is the contractor in compliance with the terms and conditions of the contract that are related to small business participation?. Is the contractor meeting small business goals? Is the contractor making a good faith effort to meet small business subcontracting goals?

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

6. Regulatory Compliance: Is the contractor in compliance with all regulations and codes regarding financial, environmental, labor, and safety. Is the contractor meeting the reporting requirements in a timely manner?

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

7. Business Relationships: Has the contractor demonstrated effective management over the effort performed?

Maintained an open line of communication so that the COR and/or CO/CS is apprised of technical, cost, and schedule issues? Did the contractor present information and correspondence in a clear, concise, and businesslike manner? Did the contractor promptly notify the COR/CS/CO in a timely manner regarding urgent issues? What do you think of the contractor’s overall performance?

Please rate the above contractor substantiated by the above narration, according to the following ratings:

____ Exceptional ____ Very Good ____Satisfactory ____ Marginal ____ Unsatisfactory ____Not Applicable

Contract Dates