ATTACHMENT IV - Past Performance Report Form.doc

PAST PERFORMANCE REPORT FORM

SOLICITATION N0018922R0007

Complete and return to:

Fleet Logistics Center Norfolk (FLCN)

Contracting Department, Attn: Erik De Santis, Code 240.1

Phone: (757) 443-1409

Email: erik.j.desantis.civ@us.navy.mil and chelsey.n.crawford.civ@us.navy.mil On behalf of (Requester Information):

Company's Name:

POC/Title/Position:

Email Address:

Contract/Purchase Order No.:

Contract Amount:

Contract Type:

Period of Performance:

Business Address:

Phone Number:

NOTE:

DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS REQUEST

The completion of this questionnaire is requested from your agency/company in order for the U.S. Naval Supply System (NAVSUP) Fleet Logistics Center Norfolk (FLCN) to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract.

Completed by :

Command/Company’s Name:

POC/Title/Position:

Email Address:

Address:

Phone Number:

1. Quality/Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.

a. What volume of inventory was the contractor responsible for managing under the referenced contract? How well did they manage the inventory in accordance with the contract requirements?

b. How would you describe your level of customer satisfaction?

c. Were there instances of rework and/or deficiency reports? (If yes, explain)

d. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?

2. Quality/Timeliness.

a. Was the contractor required to adjust inventory requirements based on changing customer demands throughout contract performance? If so, what turnaround times were required? How well did the contractor respond to the inventory change requests and were they timely?

b. Describe the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

c. Describe the timeliness of submission of requested information, reports and invoicing.

3. Quality/Contractor Responsiveness. The offeror’s demonstrated ability to:

a. respond to customer concerns

b. isolate and resolve problems

· the number and severity of problems

· the effectiveness of corrective actions taken.

c. Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/under-run, Government-imposed schedule changes, etc.)

4. Additional Observations/Information

a. Identify the contractor's overall strengths and weaknesses.

b. Given hindsight, are you satisfied that the contract was awarded to this contractor? Would you be pleased to have this contractor perform work for you again? Why?

c. Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

d. Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.

(If more comment space needed, please attach additional pages.)

Source Selection Information – See FAR 2.101 and 3.104