Attachment J.4_Past Performance Reference Questionnaire.docx

RFP No. 72051923R00004

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104

WHEN COMPLETED, FOR OFFICIAL USE ONLY

ATTACHMENT J.4

PAST PERFORMANCE REFERENCE QUESTIONNAIRE

Offeror Instructions: Complete Transmittal Letter and Section 1 of the Past Performance Questionnaire (PPQ) and send to the assessor(s). Ensure assessor returns a copy of the completed questionnaire to the USAID POCs identified below prior to the solicitation closing date and time.

Assessor Instructions: Confirm accuracy and completeness of Section 1 of the PPQ. Complete Section 2 of the PPQ and submit Sections 1 and 2 directly to the Contracting Officers. Do not forward a copy of the completed questionnaire to the vendor whose performance you are evaluating. To be considered, the information must be received by the Government prior to the solicitation closing date and time.

INSERT DATE

SUBJECT: Past Performance Questionnaire for (PROGRAM TITLE/DESCRIPTION) concerning contract number (CONTRACT AND ORDER NUMBER (IF APPLICABLE) TO BE EVALUATED). The effort was performed by (SPECIFIC ENTITY THAT PERFORMED THE WORK) under (CAGE code/UEI#).

1. We are currently responding to the USAID’s Request for Proposal (RFP) 72051923R00004. The Government is placing increased emphasis on past performance in order to obtain best value in source selections.

2. We have identified the subject contract as relevant to this acquisition and you as our POC. As such, please take a few moments of your time to fill out the attached questionnaire and forward it directly to USAID. DO NOT RETURN THE COMPLETED QUESTIONNAIRE TO US. The information contained in the completed questionnaire is considered Source Selection Information (See FAR 2.101 and FAR 3.104) and may not be released to us.

3. The completed questionnaire (Sections 1 and 2) should be sent directly to USAID not later than (DATE TO BE INSERTED BY OFFEROR). The questionnaires must be emailed to Amavroukakis@usaid.gov, Acarrera@usaid.gov and Aquinonez@usaid.gov.

4. If you have any questions regarding the questionnaire, you may contact Alejandra Quinonez via email at Aquinonez@usaid.gov. Thank you for your timely assistance.

Sincerely, (TITLE AND NAME OF COMPANY OFFICIAL)

Attachment: Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

SECTION 1 – TO BE COMPLETED BY OFFEROR

This Past Performance Questionnaire is submitted in response to solicitation 72051923R00004 as part of <insert name of prime offeror> proposal.

1. Company Information: Include name, address, and cage code of company (i.e. offeror, partner, or major subcontractor) for which this reference will be provided.

2. Program Title:

3. Contract Number (including Delivery / Task Order number if applicable):

4. Contract Award Basis: ☐ Competitive ☐ Non-Competitive

5. Contract Date:

6. Role: ☐ Prime Contractor ☐ Subcontractor ☐ Other: (Specify)

If other than a prime contractor, provide the prime contractor’s name, address, and cage code:

7. Name and Address of Contracting Activity:

8. Primary Points of Contact: Offeror is responsible for exerting its best efforts to ensure that current information is provided for all individuals.

1. Primary CO

2. Secondary CO (if applicable i.e. ACO)

3. COR

4. Other (Please Specify)

9. Contract Type(s): List all that apply (e.g. FFP, FPIF, CPFF, CPAF, CPIF, LH, T&M).

10. Contract Value:

11. Period of Performance: MM/DD/YEAR to MM/DD/YEAR

12. Place of Performance: List all that apply.

13. Scope of work

a. Describe work performed by the company named in item 1 above:

b. Relevancy: Provide information that demonstrates why this reference is relevant to this solicitation. Explain what aspects of performance under this reference are deemed relevant to the proposed effort and to what aspects of the proposed solicitation they relate to.

14. What were key positive attributes about your performance?

15. What were the less than positive attributes and how were these resolved? The offeror is required to clearly demonstrate management actions employed in overcoming problems and the effects of those actions in terms of improvements achieved or problems rectified. Comment on any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions.

16. Has this contract been partially or completely terminated for default or convenience?

☐ Yes ☐ No

If yes, please provide additional details:

17. Are there any pending terminations?

☐ Yes ☐ No

If yes, please provide additional details:

SECTION 2 – TO BE COMPLETED BY ASSESSOR

Your feedback is requested by the US Agency for International Development, Office of Acquisition and Assistance. In efforts to expedite receipt of the requested information, the Contracting Officer respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire (both Section 1 and Section 2) to Amavroukakis@usaid.gov, Acarrera@usaid.gov and Aquinonez@usaid.gov.

DO NOT RETURN THE COMPLETED QUESTIONNAIRE TO THE OFFEROR. The information contained in the completed questionnaire is considered Source Selection Information (See FAR 2.101 and FAR 3.104) and may not be released to the Offeror.

EVALUATED BY:

I, the undersigned, being familiar with the work and the performing organization I’m providing information about, have responded to the best of my knowledge and belief. I understand that a representative of USAID may contact me for confirmation of my responses to this questionnaire.

1. Is the information completed by the Offeror in Section 1 of this questionnaire complete, current, and accurate?

If no, please explain:

2. Performance Evaluation

Assign a rating to each area based on the ratings guidelines below. Please provide a narrative explanation for any unsatisfactory or exceptional rating.

a. Quality of Services:

1. Contractor provided personnel with the appropriate qualifications and experience required to perform the contract.

2. Performance conformed to contract requirements, specifications, and standards of good workmanship (e.g. commonly accepted technical, professional standards).

3. Contractor provided accurate and complete reports and other documentation.

4. Contractor was proactive in identifying, notifying the Government, and resolving performance issues/concerns.

b. Compliance with Schedule:

1. Contractor performed services in a timely manner.

2. Contractor provided contract reports and deliverables on time.

c. Cost Control:

1. Contractor completed performance within the established cost parameters.

2. Contractor invoices were current, accurate, and complete.

3. Contractor actions resulted in cost savings to the Government without sacrificing quality of services or schedule.

d. Business Relations:

1. Contractor has a history of reasonable and cooperative behavior and effective business relations.

2. Contractor is dedicated to customer satisfaction.

3. Contractor has a history of submitting viable and timely proposals for required contract modifications or task orders.

4. Contractor effectively adapts to changes in mission requirements and priorities.

e. Management

1. Contractor effectively selected, retained, supported, and replaced (when necessary) personnel with the experience and expertise necessary to accomplish the Government’s requirement.

2. Contractor adequately managed and controlled government furnished property.

3. Contractor effectively managed all subcontractors.

f. Performance in using Small Business (SB) Concerns (as defined in FAR 19.001) - Other than Small Businesses only

1. Utilization of small business concerns as subcontractors.

2. Contractor’s efforts in achieving small business participation goals as set out in their Small Business subcontracting plan for the contract.

3. Would you have any concerns working with this firm again?

If yes, please explain:

4. Additional information not included above:

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104

WHEN COMPLETED, FOR OFFICIAL USE ONLY