Attachment X_Past_Performance_Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

FOR SOLICITATION NUMBER N0017423R0074

Offeror’s Name:

Name of agency/activity completing questionnaire:

Name and title of the person completing questionnaire:

Contract Number/Period of Performance: __________________________________________________

Length of time your agency/activity has been involved with the Offeror:

Brief description of the services provided by the Offeror:

SUBMIT PAST PERFORMANCE QUESTIONNAIRE PRIOR TO THE CLOSING DATE OF THE SOLICITATION TO:

Naval Surface Warfare Center

Indian Head Explosive Ordnance Disposal Technology Division (NSWC IHEODTD)

4081 North Jackson Road

Room 125, Code 026F Indian Head, MD 20640-5115 e-mail address: waylin.m.duhon.civ@us.navy.mil

RATING SCALE

Please use the following ratings to answer the questions.

EVALUATION CRITERIA

Exceptional: Performance meets contractual requirements and exceeds many to the customer’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the customer’s benefit. The 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 element being assessed 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 element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem (s) for which the contractor’s corrective actions appear or were ineffective.

NEUTRAL - The Offeror lacks a relevant past performance record or past performance information is not available or cannot be determined. The Offeror will not be evaluated favorably or unfavorably on past performance.

CUSTOMER SATISFACTION

The referenced contractor was responsive to the customer’s needs.

The contractor’s personnel were qualified to meet the requirements.

The contractor’s ability to accurately estimate cost.

TIMELINESS

The contractor’s ability to ensure, to the extent of its responsibility, that all tasks were completed within the requested time frame.

TECHNICAL SUCCESS

The contractor had a clear understanding of the tasks detailed in the SOW and/or delivery orders.

The contractor’s ability to complete tasks correctly the first time.

The contractor’s ability to resolve problems.

PROGRAM MANAGEMENT

Did the contractor successfully manage its subcontractors?

Was the contractor’s management effective in controlling cost, schedule and performance requirements?

QUALITY

The contractor’s quality and reliability of services delivered.

OVERALL

Please assign an overall rating for the contractor’s work performed.

PLEASE PROVIDE SUBJECTIVE RESPONSES FOR THE FOLLOWING:

1. Would you recommend this contractor for similar contracts? Please explain:

2. Have you experienced special or unique problems with the referenced contractor that the Government should be aware of in making our decision?

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SOURCE SELECTION INFORMATION

See FAR 2.101 and 3.104