B08 - ATTACHMENT B - PAST PERFORMANCE QUESTIONAIRE.pdf

When Completed – Source Selection Information – See FAR 3.104

ATTACHMENT B

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER: W81XWH-20-R-0023

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION

IAW FAR 3.104

(a) Please complete this questionnaire. Electronic responses are sufficient. If you need more space than that provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information. Scan and email or fax the completed questionnaire to:

NAME: Ms. Chelsey Jahn Office USAMRAA-SB6 Telephone 301-619-2431 Email Chelsey.n.jahn.civ@mail.mil

Explanation of codes:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL – performance meets contractual requirements and exceeds many requirements to the Governments benefit. The contractual performance of the elements being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V Very Good – performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance of the elements being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance of the elements being assessed contains 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 of the elements being assessed 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the elements being assessed contains serious problem(s) for which the contractor’s corrective actions were ineffective.

N NOT APPLICABLE – Unable to provide a score. Performance in this area not applicable to effort assessed.

(b) Please complete the following identifying information and past performance assessment To be completed by offeror

A. Contractor:

B. Contract number:

C. Period of Performance:

D. Negotiated price or cost at award:

E. Current estimated contract dollar amount:

F. Describe services completed:

To be completed by point of contact (respondent) (d)Checkmark the appropriate letter for each item on the questionnaire and provide supporting narrative.

ASSESSMENT ELEMENTS

(1) Did the contractor deliver according to the agreed-to schedule? What were the causes of any schedule variances?

Did the contractor require assistance to resolve any schedule problems?

E V S M U N

(2) How well did the contractor proactively manage schedule/performance/cost and risks?

E V S M U N

(3) How well did the contractor perform multiple projects?

E V S M U N

(4) What is your overall rating of the contractor’s performance?

E V S M U N

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

E V S M U N

(6) Identify the contractor’s overall strengths and weaknesses.

(7) Given the choice, would you award to this contractor again?

(8) 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.

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

5. Please provide company, name, title, address, and phone number of the person completing this questionnaire.

AGENCY/COMPANY:______________________________________________________________________ NAME:___________________________________________________________________________________ ADDRESS:________________________________________________________________________________ PHONE NUMBER:_________________________________________________________________________