8C_Past_Performance_Survey.pdf

DJM-17-A32-R-0001

Small Business Set Aside Federal Judicial Districts D17 and D26

Attachment 8(C) Past Performance Survey

1) Contracting Activity/Organization Information: (Recipient of Past Performance)

Entity Name (Include Division if applicable)

Street Address

City State Zip Code

2) Evaluator Information:

Name

Phone Number Email Address

Role Contracting Officer Administrative Contracting Officer

Program Manager Contracting Officer's Representative

Other

3) Contract Information:

Contract Number NAICS Code (If Applicable)

Company Name

Contract Relationship Prime Contractor Subcontractor

If Subcontractor, Name of Prime

Status Active

Completed

Total Contract Value (Base + Option Years)

Award Date Period of Performance to

Original Estimated Completion Date

Actual Completion Date

Explanation for Schedule Variance

(if applicable)

3) Contract Information: (Continued)

Contract Method and Type of Contract

Commercial Performance Based Requirements

FAR 15 Negotiated Blanket Ordering Agmt. ID/IQ

Labor Hour Time & Material Competitive

Non-Competitive Set-Aside Small Business / 8(a)

Sm Biz Innovation Resrch. Fixed Price (FP) FP Incentive

FP Economic Price Adj. Award Fee Cost Reimbursement

Cost + Fixed Fee Cost + Incentive Fee Cost + Award Fee

Other

Description of the Requirement

List of major Subcontracts and their contribution to the overall value of the contract (percentage)

4) Past Performance Reporting:

Past Performance Information

SAM FAPIIS PPIRS

Other

For Current Contracts under CPAR Evaluations: Has the scope of work significantly changed since the last CPAR. For example, during the last CPAR period, the contractor was primarily doing design work, but now the program has entered into the testing phase.

No, current work similar to last CPAR effort

Yes. Please Explain

For Current Contracts under CPAR Evaluations: Have there been any significant changes in contract performance between your last CPAR and now? For example: 1) For any previous Marginal or Unsatisfactory rating, has the contractor demonstrated and exhibited systemic improvements that perhaps would be reflected in a different rating on your next CPAR or 2) contractor schedule performance has declined significantly from last CPAR reporting period, e.g. rating was a Satisfactory and might become a Marginal or Unsatisfactory on your next CPAR

No, current performance is similar to last CPAR performance

Yes. Please Explain

5) Past Performance Evaluation:

Summarize contractor performance and assign a rating that corresponds to the contractor's performance for each element. Please expand on attachments as necessary. Please see attachment 8(B) Past Performance Rating Guidelines for an explanation of the rating scale.

SUBJECT COMMENTS RATING

Quality of Service (as defined in contract standards/statement of work) Please address post staffing, post coverage, employee training,employee grooming, and performance violations.

E

VG

S

M

U

N/A

Schedule Performance Please address timeliness as it relates to staffing, training, and including timely completion of all administrative requirements to the customer's satisfaction.

E

VG

S

M

U

N/A

Costs (demonstrated financial capability in ability to meet payroll and other commitments) Please address ability to meet all overall cost estimates and pricing while meeting all contractual requirements.

E

VG

S

M

U

N/A

5) Past Performance Evaluation: (Continued)

SUBJECT COMMENTS RATING

Small Business Utilization Has the contractor made a good faith effort to meet the subcontracting goals outlined in their subcontracting plan.

Please note: The evaluator may need to contact the cognizant contracting officer to ascertain if the company is meeting subcontracting goals.

E

VG

S

M

U

N/A

Key Personnel (ability of corporate personnel to administer and mange contract) Please address staffing levels; workflow;

delegations of authority; reporting;

and internal and external communications.

E

VG

S

M

U

N/A

Business Relations (history of professional behavior and overall business-like concerts for the interest of the customer) Please address responsiveness, follow through, and customer satisfaction.

E

VG

S

M

U

N/A

6) Further Information

Have there been any problems or mitigating circumstances which the offeror has made known to balance the negative evaluations, if any, of those named in the above CPAR update or evaluation table.

Any additional information.