EXHIBIT 17 - Past Perf Questionnaire.pdf

Exhibit 17

RFP #80HQTR20R0016

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

Sections 1-3 provide for contract-related descriptive information and identification of the evaluator.

Section 4 lists the major work elements within our Statement of Work (SOW). Please provide your assessment of the “relevant experience” and “performance” associated with our SOW evidenced within the contract for which you are a reference. “Experience” means a contractor who has performed work in the specific SOW Element. “Did not Perform” means that the specific SOW element was not performed under the contract.

Section 5 evaluates the contractor’s technical, schedule, and cost performance and management. (Additional pages may be used for comments if desired). If you cannot answer any questions, please circle “N/R” for Not Rated.

The following definitions are offered for your use in assigning a performance rating for each of the factors in Sections 5 and 6:

Very High

(VH)

The Offeror’s relevant past performance is of exceptional merit;

indicating exemplary performance in a timely, efficient, and economical manner; very minor (if any) problems with no adverse effect on overall performance.

High

(H)

The Offeror’s relevant past performance demonstrates very effective performance that would be fully responsive to contract requirements with contract requirements accomplished in a timely, efficient, and economical manner for the most part with only minor problems with little identifiable effect on overall performance.

Moderate

(M)

The Offeror’s relevant past performance demonstrates effective performance; fully responsive to contract requirements; reportable problems, but with little identifiable effect on overall performance.

Low

(L)

The Offeror’s relevant past performance meets or slightly exceeds minimum acceptable standards; adequate results; reportable problems with identifiable, but not substantial, effects on overall performance.

Very Low

(VL)

The Offeror’s relevant past performance does not meet minimum acceptable standards in one or more areas; remedial action required in one or more areas; problems in one or more areas which, adversely affect overall performance.

N/R Not Rated

Section 6 provides for evaluation of the contractor’s management of cost and award/incentive fee history.

RETURN THIS QUESTIONNAIRE TO NASA Goddard Space Flight Center BY TBD. Attn: Cassandra K. Moore, Code 210.H Greenbelt, MD 20771 Phone: 301-286-4754 e-mail: Cassandra.K.Moore @nasa.gov

PAST PERFORMANCE QUESTIONNAIRE

1. Contract Information

A. Name of Company/Division Being Evaluated:_____________________

B. Address:_____________________________________________

C. Contractor Cage Code and/or DUNS number

D. Contract Number:_______________________________________

E. Contract Type:_________________________________________

F. Period of Performance (including options): From:______ To:_______

G. Total Contract Value:_____________________________________

H. Award Information: Competitive: Yes___ No___ Basis of Selection: Technical___ Cost/Price___ Other (specify)_________________________

2. Description of Contract

Briefly describe the services provided under this contract:

During the contract performance being evaluated, this firm was the:

Prime Contractor____ Significant Subcontractor ____ Team Member ____ Other (describe)____________________________________________

Does a corporate or business relationship exist between the firm being evaluated and your organization?

Yes ___ No ___. If yes, please describe: ___________________________

3. Evaluator Information

Name: _____________________________________________________ Title: _______________________________________________________ Agency/Company: ____________________________________________ E-mail Address: _______________________________________________ Phone: ______________ Date Questionnaire Completed: _____________ Role in Program/Contract: ______________________________________ Length of Involvement in this Program/ Contract: _____________________

This form contains Source Selection Information when completed. See FAR 3.104. 3

4. SOW Survey Relevance Ratings: Please check the appropriate blocks for Relevance (Performed or Did Not Perform)

SOW ELEMENT

PERFORMED

DID NOT

PERFORM

Program coordination, facilitation, and day-to-day operational support for a highly-visible consortium or inter-agency collaboration that coordinates research, assessment, outreach and related activities.

Provision of technical and operational expertise to support the end-to-end production of domestic and international scientific assessments.

Technical and operational support for end-to-end production of non-assessment strategic documents and technical reports.

Coordination and support of planning and budget activities for a highly-visible consortium or inter-agency collaboration that coordinates research, assessment, outreach and related activities.

Communication and stakeholder outreach activities in support of the objectives of a highly-visible consortium or inter-agency collaboration that coordinates research, assessment, outreach and related activities.

Technical support, development, and management of a web presence, public online information resources, and office network and applications for a highly-visible consortium or inter-agency collaboration that coordinates research, assessment, outreach and related activities.

Support of high-profile, episodic or limited term program activities and deliverables through Task Orders.

This form contains Source Selection Information when completed. See FAR 3.104. 4

5. General Performance Survey

NO PERFORMANCE QUESTIONS

PERFORMANCE RATING

(Please Circle)

QUALITY

1. Quality of services and support provided VH H M L VL N/R

2. Timely identification and mitigation of risks VH H M L VL N/R

3.

Timeliness, quality, and accuracy of schedule reporting

VH H M L VL N/R

4.

Ability to identify and correct performance deficiencies in a timely manner

VH H M L VL N/R

5.

Demonstrated understanding and compliance with technical requirements and performance standard requirements

VH H M L VL N/R

6. Ability to handle fluctuating workloads VH H M L VL N/R

Comment:

SCHEDULE

7.

Content, accuracy, quality, and timeliness of technical reports and deliverables

8. Ability to meet/exceed schedule milestones VH H M L VL N/R

COST

9.

Ability to establish realistic cost estimates and adhere to estimated costs

VH H M L VL N/R

10.

Ability to anticipate, identify and control cost growth.

VH H M L VL N/R

11.

Ability to design and/or deliver required reports that meet or exceeds performance requirements within costs and schedule

VH H M L VL N/R

12.

Adherence to estimated costs and contract cost targets

VH H M L VL N/R

13.

Timeliness, quality, and accuracy of financial reporting

BUSINESS/MANAGEMENT

14.

Communicating/interfacing with Government and overall responsiveness to Government requests

VH H M L VL N/R

15.

Ability to effectively manage the contract including subcontractor performance

VH H M L VL N/R

16.

Ability to recruit and retain highly skilled personnel, including ability to fill key vacancies in a timely

This form contains Source Selection Information when completed. See FAR 3.104. 5 manner.

17.

Ability to build effective working relationships with associate contractors, subcontractors and the Government in a team environment

VH H M L VL N/R

18.

Adequacy of Contractor’s system(s) for processing task orders and/or changes.

VH H M L VL N/R

19. Overall responsiveness to Government requests VH H M L VL N/R

20.

Ability to meet Small Business Subcontracting Plan Goals

Section 6:

What is the Contract Value:

Initial Value Current Value Estimated Cost: $___________ $____________

Fee: $___________ $____________

Total Value: $___________ $_____________

What are the total contract expenditures to date (cost/fees to date based on invoices, reports, etc)?

What is the Annual Contract Value to Date (The current contract expenditures to date divided by the number of years of performance to date)?

For example (note, these example numbers may not relate to this specific procurement):

Assume your contract is a current five year contract, is still ongoing, and the latest cost report reflects a cost/fee of $43,500,000 through the first 2 years and 4 months (to date). In this example, current/total Contract Expenditures incurred to Date are $43,500,000 and associated period of performance for those expenditures, expressed in years, is 2.33 years.

Therefore, the Average Annual Cost/Fee Incurred to Date: $18,669,528 ($43,500,000/2.33 years)

Was there a cost overrun? ( ) Yes ( ) No If yes, please explain:

If this was an award fee contract, what are the individual and/or average ratings of performance by your organization? Please attach any available award fee letters or database entries.

This form contains Source Selection Information when completed. See FAR 3.104. 6

Please comment on particularly strong/weak points of Contractor’s performance (technical, schedule, and/or cost). If the Overall Contract Performance Rating below is less than Very High, please provide some explanation in this section on why a higher rating was not provided.

Overall Contract Performance Rating (circle one)

Very High High Moderate Low Very Low

If less than Very High Performance Rating, please explain:

Please add any other comments you may feel are pertinent.

Rater’s Signature Date