Exhibit-B Performance Assessment Questionnaire.docx
DOCX document 61 KB Posted
- Solicitation number
- M0068125R0014
- Issued by
-
United States Marine Corps
About this file
This document is a Performance Assessment Questionnaire for a United States Marine Corps contract (RFP M0068125R0014) related to SCBA (Self-Contained Breathing Apparatus) equipment testing. The questionnaire is designed to collect past performance information from previous contractors, with a focus on evaluating offerors for an annual SCBA flow testing and one-time hydrostatic testing of carbon cylinders contract. The assessment covers key performance areas including compliance with specifications, project management effectiveness, timeliness of performance, cost control, and customer satisfaction.
The document provides a detailed rating scale with four confidence levels: Substantial Confidence, Satisfactory Confidence, Limited Confidence, and No Confidence. Recipients are asked to complete and return the questionnaire within 15 days to corey.slivnik@usmc.mil and maria.caceres@usmc.mil. The contract is associated with Marine Corps installations in Camp Pendleton, Barstow, Miramar, and 29 Palms, with an expected performance period beginning on 23 September 2025. The evaluation is specific to North American Industry Classification System (NAICS) code 811310 and involves testing of Government-owned Scott Safety 3M brand SCBA equipment and carbon cylinders.
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Text version
UNITED STATES MARINE CORPS
MARINE CORPS INSTALLATIONS WEST-MARINE CORPS BASE BOX 555010SS
CAMP PENDLETON, CALIFORNIA 92055-5010
SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) M0068125R0014
Dear Sir/Ma’am, The US Marine Corps MCI-West is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on same or similar federal, state, or local government or commercial contracts as compared to the North American Industry Classification System (NAICS) 811310. You have been identified as the point of contact cited on the enclosure.
Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the Regional Contracting Office MCI-West, no later than 15 days after receipt of request. Submit your completed questionnaire to corey.slivnik@usmc.mil and maria.caceres@usmc.mil.
Your cooperation is greatly appreciated. Questions may be directed to the undersigned.
Sincerely, MARIA CACERES
Contracting Officer
Performance Assessment Questionnaire
Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does and notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.
Rating Definitions:
Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.
Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.
Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions, or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.
No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.
PART I. (To be completed by the Offeror)
A. CONTRACT IDENTIFICATION
Contractor/Company Name/Division: ________________________________________ Address: ______________________________________________________________ Program Identification/Title: _______________________________________________ Contract Number: _______________________________________________________ Contract Type: _________________________________________________________ Prime Contractor Name (if different from the contractor’s name cited above): __________ Contract Award Date: ____________________________________________________ Forecasted or Actual Contract Completion Date: _______________________________ Nature of the Contractual Effort or Items Purchased: ____________________________ Total Contract Value: ____________________________________________________
B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE
Name: ________________________________________________________________ Title: _________________________________________________________________ Date: _________________________________________________________________ Telephone Number: _____________________________________________________
E-mail Address: ________________________________________________________
PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.
A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship
☐Substantial Confidence ☐Satisfactory Confidence ☐Limited Confidence ☐No Confidence
Rationale: _________________________________________________________
B. Effectiveness of Project Management (to include use and control of subcontractors).
☐Limited Confidence ☐No Confidence
Rationale: __________________________________________________________
C. Timeliness of Performance for Services and Product Deliverables.
☐Limited Confidence ☐No Confidence
Rationale: __________________________________________________________
D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).
☐Limited Confidence ☐No Confidence
Rationale: __________________________________________________________
E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest
☐Limited Confidence ☐No Confidence
Rationale: __________________________________________________________
F. General Comments. Provide any other relevant performance information.
Comments: _________________________________________________________
G. Other Information Sources. Please provide the following information:
Are you aware of other relevant past efforts by this company?
If yes, please provide the name and telephone number of a point of contact:
Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________
H. Respondent Identification. Please provide the following information:
Organization: __________________________________________________________ Name: ________________________________________________________________ Title: _________________________________________________________________ Date: _________________________________________________________________ Telephone Number: _____________________________________________________
E-mail Address: ________________________________________________________
PART III. RETURN INFORMATION
Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.
Thank you for your assistance.
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