J.4 - PAST PERFORMANCE SURVEY AND INSTRUCTIONS - 08142008.doc

ATTACHMENT J.4

DEPARTMENT OF LABOR (DOL) - CONTRACTOR PAST PERFORMANCE SURVEY

INTRODUCTION

The Department of Labor (DOL) is currently conducting a competitive procurement solicitation entitled “RFP DOL089RP20589” for which the prospective offeror/applicant (except states, local governments or universities) has been requested to identify Government agencies or commercial business firms it has previously contracted with or to whom it is currently under contract, to serve as potential references on its past performance record. You are being asked to complete the attached Contractor Past Performance Survey. Parts I and II are to be completed and returned by the offeror/applicant with its submission. Part III should be completed by the evaluator/respondent and forwarded directly to DOL (See Note below regarding Part III transmittal.) You may also be contacted by a DOL procurement official to arrange a telephone interview, using the survey as the focal point of the interview.

To ensure frank and open evaluations and expressions of opinions by evaluators, all parties are advised that the identity of respondents completing the survey will be held in confidence and will not be released or disclosed to the contractor or outside the Government. However, as specified under Federal Acquisition Regulation (FAR) 15.306, conditions may exist in which the contractor may be provided an opportunity to discuss adverse past performance information on which the contractor has not had a previous opportunity to comment. Any relevant contractor performance/customer evaluations previously prepared within the last three (3) years by the agency/firm providing this reference, and subsequent responses or rebuttals from the contractor, may be requested to augment or furnished in lieu of this survey or interview.

NOTE: Part III – “Evaluator’s Assessment” of this survey should not be returned or furnished in a copy to the subject offeror/applicant. The evaluator/respondent should mail or FAX Part III directly to: Department of Labor (DOL), Office of Procurement Services, 200 Constitution Avenue SW, Washington, DC 20210. FAX to 202/693-4579, ATTN: DOL089RP20589.

If you have any questions, please contact Mr. Gene Kippins, Tel: 202/693-7163, Email: Kippins.gene@dol.gov ; or Ms. Marissa Dela Cerna, Tel: 202/693-7192, Email: delacerna.marissa@dol.gov .

EVALUATION RATING GUIDELINES

Exceptional (5) - Performance in the respective area of evaluation, consistently and reliably far exceeded standards or expectations as set forth in the contract, or as prior experience and knowledge of the industry would suggest or dictate. There were essentially no major problems, weaknesses, or deficiencies of consequence, nor negative performances issues as it applies to the respective area of evaluation. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which the contractor took highly effective and timely corrective action.

Very Good (4) - Performance in the respective area of evaluation, consistently and reliably exceeded standards or expectations as set forth in the contract, or as prior experience and knowledge of the industry would suggest or dictate. There were essentially no major problems, weaknesses, or deficiencies of consequence, nor negative performances issues as it applies to the respective area of evaluation. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which the contractor took effective and timely corrective action.

Satisfactory (3) - Performance in the respective area of evaluation, consistently and reliably met standards or expectations as set forth in the contract, or as prior experience and knowledge of the industry would suggest or dictate. There were essentially no major problems, weaknesses, or deficiencies of consequence, nor negative performances issues as it applies to the respective area of evaluation. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which the contractor took competent and timely corrective action.

Marginal (2) - Performance in the respective area of evaluation, did not meet standards or expectations as set forth in the contract, or as prior experience and knowledge of the industry would suggest or dictate. There were problems, weaknesses, or deficiencies of consequence, or negative performances issues as it applies to the respective area of evaluation. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems and one or more major problems for which the contractor took minimal or ineffectual and/or untimely corrective action.

Unsatisfactory (1) - Performance in the respective area of evaluation, failed to meet standards or expectations as set forth in the contract, or as prior experience and knowledge of the industry would suggest or dictate. There were problems, weaknesses, or deficiencies of consequence, or negative performances issues as it applies to the respective area of evaluation. The contractual performance of the element or sub-element being assessed was accomplished with numerous minor and numerous major problems for which the contractor took virtually no, or minimal or ineffectual, and/or untimely corrective action.

PART I - ADMINISTRATION – Contractor Past Performance Survey

(To be completed by Offeror /Applicant and submitted with its Offer/Submission)

Name of Agency/Business

Reference Conducting Assessment:

Contract or Project Title:

Contract No. Delivery/Task Order No.

Performance Period(s): Base Period- from to & Base plus All Options - from to

Dollar Value(s): Base Period - & Base plus All Options -

Contract Type and Method of Contracting: (Check all that apply)

[ ] Full & Open Competition [ ] Other Than Full & Open Competition

[ ] Negotiated [ ] Sealed Bid [ ] Simplified Acquisition [ ] FSS/MAS [ ] 2-Step or Phased

[ ] Firm Fixed Price [ ] Other FP type (specify)

[ ] Cost (no fee) [ ] Cost Plus Fixed Fee [ ] Other Cost Reimbursement type (specify)

[ ] Other Contract type (specify)

[ ] SBA 8(a) [ ] SBIR [ ] HUBZone Set-Aside [ ] SDB Price Adjustment [ ] Small Business Set-Aside

PART II - RELEVANCY/PERSPECTIVE – Contractor Past Performance Survey

(To be completed by Offeror/Applicant and submitted with its Offer/Submission)

For Part II, the offeror shall complete and insert a single page that addresses the following three areas of inquiry: Description of Prior Contract Services, Relevancy, and Problem Resolution and Quality Honors. The text of the offeror's responses for all three inquiries combined shall not exceed one page.

Description of Prior Contract Services: Provide a short description of supplies/services the offeror furnished in the referenced contract evaluated herein.

(Recommend 5 -10 lines.)

Relevancy: Describe how the referenced contract evaluated herein is relevant (in terms of scope, magnitude, cost, human resources, or other aspects) to the research project, technology advancement and/or demonstration being proposed in the offeror's proposal concept paper submitted. Identify whether the offeror was the prime contractor or a major subcontractor (in terms of total contract cost, 25% or more), or served in some other capacity/role or relationship. Provide name, point of contact and phone number of prime contractor, if other than offeror.

(Recommend 20 -25 lines.)

Problem Resolution and Quality Honors: The offeror may describe problems encountered in the identified contract and the demonstrated effectiveness of the offeror's corrective actions. Identify any Federal Government contracts/orders, of any type, at any dollar value, held by the offeror which were terminated for cause or for default (partial or complete) within the past three (3) years and subsequent corrective action. The offeror may also describe any specific quality awards or quality certifications received in connection with the referenced contract.

(Recommend 15 -20 lines.)

RFP DOL089RP20589

S O U R C E S E L E C T I O N I N F O R M A T I O N

The disclosure of which is restricted. See FAR 3.104

NOTE: DO NOT RETURN OR FURNISH A COPY OF THIS PART III TO THE SUBJECT OFFEROR/APPLICANT. The evaluator/respondent should complete this part and mail or FAX it directly to Department of Labor (DOL), Office of Procurement Services, 200 Constitution Avenue SW, Washington, DC 20210. FAX to 202/693-4579, ATTN: DOL089RP20589. If you have any questions, please contact Mr. Gene Kippins, Tel: 202/693-7163, Email: Kippins.gene@dol.gov ; or Ms. Marissa Dela Cerna, Tel: 202/693-7192, Email: delacerna.marissa@dol.gov .

PART III - EVALUATOR/RESPONDENT=S ASSESSMENT

(To be completed and signed by referred Evaluator/Respondent for DOL089RP20589)

Contractor: __________ Contract No. _________________________

1. Quality of Product or Service - The offeror is to be evaluated on its compliance with contract requirements, accuracy of reports, technical excellence to include quality awards/certificates, or data or other quality-related contract standards.

(Check one)

(Check one)

Use remaining space (and additional cross-referenced sheets, as necessary) to B

(1) Explain the rationale for the assigned adjectival/numerical rating (i.e., recount specific extraordinary or poor contractor performance, or problems and responses that support assessment) , and (2) Describe the basis for any responses to these questions.

2. Timeliness of Performance – The offeror is to be evaluated on meeting milestones, reliability, responsiveness to technical direction, deliverables completed on-time, adherence to contract schedules including contract administration, or other time-related contract standards.

(Check one)

Use remaining space (and additional cross-referenced sheets, as necessary) to B

(1) Explain the rationale for the assigned adjectival/numerical rating (i.e., recount specific extraordinary or poor contractor performance, or problems and responses that support assessment) , and (2) Describe the basis for any responses to these questions.

Contractor: _____________ Contract No. _________________________

3. Cost Control - The offeror is to be evaluated on its ability to perform within or below budget, use of cost efficiencies, relationship of negotiated costs to actuals, submission of reasonably priced change proposals, and providing current, accurate, and complete billing in a timely fashion. For firm fixed price (FFP) contracts, this area assesses whether the contractor met the original price/cost estimated or needed to negotiate cost changes to meet program

/project requirements.

(Check one)

Use remaining space (and additional cross-referenced sheets, as necessary) to B

(1) Explain the rationale for the assigned adjectival/numerical rating (i.e., recount specific extraordinary or poor contractor performance, or problems and responses that support assessment) , and (2) Describe the basis for any responses to questions.

4. Business Relations - The offeror is to be evaluated on its ability to provide effective management, meet applicable subcontractor and small, small disadvantaged, and women-owned business goals, cooperative and proactive behavior with the technical representative(s), Contracting Officer’s Technical Representative (COTR) and Contracting Officer, flexibility, responsiveness to inquires, problem resolution, and customer satisfaction with the overall performance, and final product or services.

BUSINESS

RELATIONS

Corresponding Adjectival & Numerical Ratings (Circle one)

Use remaining space (and additional cross-referenced sheets, as necessary) to B

(1) Explain the rationale for the assigned adjectival/numerical rating (i.e., recount specific extraordinary or poor contractor performance, or problems and responses that support assessment) , and (2) Describe the basis for any responses to these questions.

DOL089RP20589.

5. Evaluator’s Identification/Signature

Contractor: _________________ Contract No. _______________________ Name of Evaluator/Respondent:

Position or Title:

(e.g., COTR, Task Monitor, Project Manager, etc.):

Address of Activity/Business:

Telephone No. Fax No. Email Address:

Signature: Date: ____________________

(To be completed by the Government Interviewer only when survey is completed on behalf of the

Evaluator /Respondent. Otherwise leave blank.)

Name of Interviewer:

Telephone No. Fax No. Email Address:

Signature: Date of Interview:

NOTE: In accordance with federal guidelines, the Government reserves the right to update and revise this document.

DOL089RP20589

S O U R C E S E L E C T I O N I N F O R M A T I O N

The disclosure of which is restricted. See FAR 3.104

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