ATTACHMENT_12__PAST_PERFORMANCE_QUESTIONNAIRE.docx

FA2517-15-R-7001

ATTACHMENT 12 – PAST PERFORMANCE QUESTIONNAIRE

ATTACHMENT 12 – PAST PERFORMANCE QUESTIONNAIRE

When completed, this document is source selection sensitive IAW FAR 2.101 and FAR 3.104

INSTRUCTIONS TO OFFERORS SENDING REFERENCE QUESTIONNAIRE FORMS:

Section A (Part I and Part II) shall be completed by the Offeror (the team requesting the reference) prior to issuing the questionnaires. The Offeror shall send the questionnaires for relevant projects for work performed within the last three (3) years and work completed at least 12 consecutive months within those three (3) years to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer or Contracting Officer’s Representative. For commercial references, send to personnel with duties similar to those for Government contracts. It is the responsibility of the Offeror to follow-up and encourages references to submit the questionnaire.

INSTRUCTIONS TO PERSON PROVIDING REFERENCE:

In order to assess potential vendors under the NORAD and USNORTHCOM Information Technology Service Management (N2ITSM) Support, Indefinite-Delivery, Indefinite-Quantity (IDIQ) contract, the contracting office is obtaining past performance information with respect to each Offeror. As a reference for work performed by the firm identified in Section A of this questionnaire, your candid response will assist in the evaluation process. Please complete Section B (Part I and Part II) of the questionnaire as thoroughly as possible and submit to christian.freire@us.af.mil, with a copy submitted to carla.perkins@us.af.mil no later than the due date established in the solicitation. The subject line in the submission e-mail shall clearly indicate: N2ITSM Past Performance Questionnaire Submission for Company Name, and the message shall originate from the reference’s government or commercial e-mail system.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is a major Network Operations and Maintenance Support Contract acquisition and your input into this evaluation is greatly appreciated. If you have questions regarding this questionnaire or require assistance, please submit inquiries to christian.freire@us.af.mil.

Sincerely, CARLA PERKINS, Contracting Officer

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: MISSION SUPPORT OFFEROR INFORMATION

COMPANY NAME AND DIVISION NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

OFFEROR CAGE CODE:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT:

CONTRACT NUMBER:

COMPETITIVE CONTRACT: YES |_| NO |_|

PRICING TYPE: (Check all that apply) |_| FFP |_| FFP-EAP |_| CPFF-Completion |_| CPFF-Term |_| CPIF |_| CPAF |_| ID/IQ |_| BOA

|_| Requirements |_| Labor-Hour |_| T&M |_| CR |_| Other (Specify) _______________

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

· INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

· FINAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

ROLE ON PROJECT:

|_| PRIME

|_| SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF APPLICABLE):

|_| OTHER (EXPLAIN)

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE (e.g. CO, COR, PM):

ADDRESS:

PHONE NUMBER:

FAX NUMBER:

E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

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. The scale is defined as follows:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL – During the contract period, contractor performance is meeting (or met) all contract requirements and consistently exceeding (or exceeded) many. Very few, if any, minor problems encountered. Contractor took immediate and effective corrective action.

U UNSATISFACTORY - During the contract period, contractor performance is failing (or fail) to meet most contract requirements. Serious problems encountered Corrective actions were either ineffective or non-existent. Extensive Customer oversight and involvement was required.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect. Do not know.

Performance Element

a. Service Desk, Incident/Problem Management

b. Network Operations

c. Technical and Application Management

d. Cybersecurity Management

e. Network Operations

f. IT Service Continuity – COOP/Disaster Recover

a. Change Management

b. Configuration Management

c. Asset Management

d. Enterprise Architecture

e. Supplier Management/IT Procurement

a. Project Management

b. Service Design/Engineering

c. Requirements Analysis

d. Service Release & Deployment

e. Service Testing & Validation

f. Service Improvements/Recommendations

What were the contractor’s greatest strengths in the performance of the contract? (Use additional sheets, if necessary)

What were the contractor’s greatest weaknesses in the performance of the contract? (Use additional sheets, if necessary)

Given the choice, would you do business with this contractor again? YES_____ NO _____

Evaluator’s Signature Date