PAST_PERFORMANCE_QUESTINNAIRE_(AMENDMENT_1).docx

PAST PERFORMANCE QUESTIONNAIRE

(This questionnaire is intended as a sample. Tailor the questionnaire to your technical/management subfactors/cost/price to solicit the information your PCAG will need to make their Performance Confidence Assessment. This questionnaire should be accompanied by a transmittal letter explaining its purpose.)

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

SECTION 1 - CONTRACT IDENTIFICATION

A. Contractor: ______________________________________________________________________________

B. Cage Code of Contractor Contract Was Awarded to: _________________________________

C. Contract Number: _______________________________________

D. Task Order Number (if applicable): ___________________________

D. Contract Type: ______________________________ (FFP, FPI, Cost, CPFF, CPIF, LH, T&M)

E. Was this a Competitive Contract? Yes _____ No _____

F. Additional Past Performance Information for this Contract Available in CPARS/PPIRS? Yes _____ No _____

G. Period of Performance (including option periods): _____________________________________________________

H. Number of Users Support by this Contract: __________

I. Number of Locations/Sites Supported by the Contract: ____________

J. Initial Contract Cost: $____________________________

K. Current/Final Contract Cost: $_______________________________

L. Reasons for differences between initial contract cost and final contract costs: _____________________________________

M. Description of service provided:__________________________________________________________________________

SECTION 2 - CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or Agency Name: _________________________________________________________________

B. Customer or Agency Description (if applicable): ____________________________________________________________

C. Geographic Description of Services under this Contract, i.e., local, nationwide, worldwide, other Commands:

SECTION 3 - EVALUATOR IDENTIFICATION

A. Evaluator's Name: ____________________________________________________________________________________

B. Evaluator's Title: _____________________________________________________________________________________

C. Evaluator's Phone/Fax Number: _________________________________________________________________________

D. Evaluator’s E-Mail Address: ____________________________________________________________________________

E. 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:

PERFORMANCE LEVEL

EXCEPTIONAL (E) - Performance meets or met contractual requirements and exceeds or exceeded many to the Government's benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

VERY GOOD (VG) - Performance meets or met contractual requirements and exceeds or exceeded some to the Government's benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

SATISFACTORY(S) – Performance meets or met contractual requirements. The contractual performance of the element or sub-element being assessed contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL (M) – Performance does not or did not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

UNSATISFACTORY (U) – Performance does not or did not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor's corrective actions appear or were ineffective.

NOT APPLICABLE (NA) - Unable to provide a score.

T1. Technical Abilities of Key Staff

T2. Ability to meet acceptable quality levels specified in the Performance Work Statement

T3. Quality of deliverables

T4. Timeliness of deliverables

T5. Number of technical deliverables that rejected and requires rework or revision after initial submission

P1. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

P2. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)

P3. Ability to recruit and retain credentialed professionals

P4. Successfully responded to urgent needs, emergency and/or surge situations

P5. Quality/effectiveness of sub-contracted/teaming efforts, (i.e., contractor/sub-contractor relationship was seamless to the government

P6. Understand/complied with customer objectives and technical requirements

P7. Timeliness/effectiveness of contract problem resolution without extensive customer guidance

P8. Contractor proposed alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the customer

P9. Contractor implemented business processes based on industry Best-Practices to improve the quality and timeliness of support.

P10. The skill sets assigned by the Contractor were of the appropriate technical proficiency and experience level to fulfill the government’s requirement

P11. Ability to train Key Staff to maintain technical proficiency and currency

P12. Accuracy, and timeliness of Invoices and travel cost reimbursement documents

T/PI1. Contractor ability to plan a smooth transition/assumption of responsibilities and apply the appropriate resources and personnel

T/PI2. Contractor effectiveness on maintaining continuity of mission support while transitioning/phasing in resources and personnel to support other efforts

T/PI3. Proficiency and efficiency of contractor’s transition or assumption of tasks identified in the Performance Work Statement (PWS)/Statement of Work (SOW)

C1. Accuracy in forecasting contract costs

C2. Ability to meet forecasted/projected costs

C3. Ability to alert the Government of unforeseen costs before they occur

C4. Number of projects/tasks that incurred additional costs

C6. Sufficiency, accuracy and timeliness of cost reporting

2. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5 - NARRATIVE SUMMARY

What were the contractor’s most positive aspects in the performance of the contract (what strengths did the contractor bring to the effort)?

What were the contractor’s most negative aspect in the performance of the contract (what were the contractor’s weaknesses)? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you have any reservations about using this contractor again ?

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire via e-mail to Thompson.sheila@dol.gov