Attachment R - Past Performance Questionaire.pdf
PDF 171 KB Posted
- Attached to
- Full Food Services at Fort Stewart, GA
- Solicitation number
- W5168W-26-R-A023
- Issued by
-
Department of the Army
About this file
This is a Past Performance Questionnaire template used by federal contracting officers to evaluate contractor performance on completed or ongoing contracts during source selection processes.
The questionnaire collects comprehensive contract and performance data organized into five sections. Section 1 requests contract identification details including contractor name, CAGE code, contract number, type, competitive status, period of performance, initial and final costs, cost variance explanations, and service descriptions. Section 2 captures customer or agency information and geographic scope of services. Section 3 identifies the evaluator and their experience duration on the contract. Section 4 contains the evaluation criteria using a four-point scale (Satisfactory, Marginal, Unsatisfactory, Not Applicable) across two performance categories: Small and Small Disadvantaged Business Participation (2 metrics) and Technical Performance (10 metrics covering contract management, workforce adequacy, quality control, government property administration, contractor cooperativeness, problem resolution, technical compliance, workforce hiring and retention, and resource transition). Evaluators must provide detailed explanations for any Marginal or Unsatisfactory ratings and disclose any contract terminations for default, convenience, or pending actions. Section 5 requires a narrative summary, assessment of future solicitation reservations, and additional performance comments. The completed questionnaire is designated as Source Selection Sensitive Information and must be submitted via email to specified Army contracting personnel. A sample cover letter template is included that references an Army Food Services contract at Fort Sill's Dining Facilities, with a placeholder for response deadline dates.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Note: Questionnaire submitted by some other entity other than the reference will not be accepted.
When filled in, this document is Source Selection Sensitive Information IAW FAR 3.104.
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor __________________________________________________________________
B. Cage Code _________________________________________________________________
C. Contract Number ____________________________________________________________
D. Contract Type _______________________________________________________________
E. Was this a competitive contract? Yes _____ No _____
F. Period of performance ________________________________________________________
G. Initial contract cost $__________________________________________________________
H. Current/final contract cost $____________________________________________________
I. Reasons for differences between initial contract cost and final contract costs
J. Description of service provided _________________________________________________
SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION
A. Customer or agency name _____________________________________________________
B. Customer or agency description _________________________________________________
C. Geographic description of services under this contract, i.e., local, nationwide, worldwide, other commands
SECTION 3: EVALUATOR IDENTIFICATION
A. Name ___________________________________________
B. Title ____________________________________________
C. Phone/Fax
D. Number of years evaluator worked on subject contract
SECTION 4: EVALUATION
Please indicate your satisfaction with the contractor’s performance by placing an X in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:
Code Performance Level
S Satisfactory – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
M Marginal – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.
US Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
NA Not Applicable – Unable to provide a score.
Small and Small Disadvantaged Business Participation S M US NA
S1. Ability to meet or exceed small business and small disadvantaged business goals set forth in the approved subcontracting plan.
S2. Ability to effectively manage small business participation to meet technical performance.
Technical Performance S M US NA
T1. Overall Contract Management.
T2. Adequacy of Contractor Workforce to Perform Contract.
T3. Quality Control.
T4. Government Furnished Property Administration.
T5. Contractor was reasonable and cooperative in dealing with your staff
(including the ability to successfully resolve disagreements/disputes).
T6. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.
T7. Understand/complied with contract objectives and technical requirements.
T8. Ability to hire/apply a qualified workforce to this effort.
T9. Ability to retain a qualified workforce on this effort.
T10. Contractor ability to smoothly transition resources and personnel.
T11. Contractor effectiveness on maintaining continuity of mission support while transitioning/phasing in resources and personnel to support other efforts.
1. Please discuss each and every response for which you indicated M (Marginal) or US
(Unsatisfactory) in response to the questions above (use additional sheets, if necessary).
2. Government Contract Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?
Yes _____ Default _____ Convenience _____ Pending Terminations _____ No _____
If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.).
SECTION 5: NARRATIVE SUMMARY
Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?
Please provide any additional comments concerning this contractor’s performance, as desired.
Evaluator’s Signature Date
Thank you for your prompt response and assistance.
Please return this completed questionnaire via email to the following Contracting Officer and
Contract Specialist at: javelin.m.carouthers.civ@army.mil and cierra.j.armistead.civ@army.mil.
mailto:Christina.m.mokrane.civ@mail.mil mailto:Karina.s.haddix.civ@mail.mil
Sample Questionnaire Cover Letter
Letterhead
Date
FOR OFFICIAL USE ONLY
The Mission and Installation Contracting (MICC) – Fort Sam Houston (FSH) Contracting Center is in the process of selecting a contractor for Army Food Services. The services required are for the Army Sustainment Command’s Logistics Readiness Center (LRC) at Fort Sill’s Dining
Facilities in support of the installation food services program that support the Warfighter with flexible, efficient and cost effective service. The service encompasses dining facility management functions, food preparation, facility sanitation, and janitorial duties.
One of the considerations in proposal evaluation is the verification of the offeror’s past performance on contracts, which reflect the offeror’s ability to perform on the proposed effort.
We depend on information received from agencies such as yours, which have had first-hand experience with an offeror, for the evaluation of the offeror’s performance on those contracts.
Our areas of interest in the offeror are summarized in the enclosed questionnaire. Our schedule is extremely tight and we need your written response no later than (INSERT DATE) after your receipt of this letter. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.
To assist you in preparing your response and expediting your reply, the questionnaire may be filled out by hand and emailed to the following Contracting Officer and Contract Specialist at:
javelin.m.carouthers.civ@army.mil and cierra.j.armistead.civ@army.mil. Please email or call the Contract Specialist at: 573-596-4155 prior to transmission or if you have any questions.
Your completed questionnaire will become a apart of the official Source Selection records.
Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this source selection.
mailto:Christina.m.mokrane.civ@mail.mil mailto:Karina.s.haddix.civ@mail.mil
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