J6-PP_Questionnaire_final.pdf

Attachment J-6: Past Performance Questionnaire

Once complete, this form contains Source Selection Information IAW FAR 3.104

PAST PERFORMANCE QUESTIONNAIRE

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: ___________________________________

B. Contract number: __________________________ CAGE Code: _______________

C. Type Contract/Task Order (underline one) CPFF CPIF CPAF T&M FFP Other: _____

1. Type security clearance required: Secret TS TS/SCI SAP/SAR Other:_____

2. Facility clearance required: Secret SCIF Other_______

D. Total Contract/Task Order Current Value to Date: _____________Status: Active:__ Completed:__

E. Date of Award/Period of Performance: _______________________

F. Contract Completion Date (including extensions): ___________________

G. Was this a competitive contract? Yes ____ No _____

H. Initial contract cost: ________________ Current/Final contract cost: ________________

I. Reasons for differences between initial contract cost and final contract costs, if applicable:

J. Indefinite Delivery/Indefinite Quantity (IDIQ) Contracts only:

1. If this is a task order placed on an IDIQ contract (excluding GSA contracts), please provide the ceiling amount of the master IDIQ contract: $_________________

2. Please provide the ceiling amount of the task order referenced: $_________________

3. Period of Performance for the IDIQ contract: _______________________________

4. Period of Performance for the task order: _______________________________

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

No ____ Yes___ Default_______ Convenience_______ Pending Terminations________

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

L. Please check Program Management and/or the USSTRATCOM mission area(s) that is/are supported by this

Contract/Task Order:

_________Program Management

_________Strategic Deterrence

_________Space Operations

_________Cyberspace Operations

_________Joint Electronic Warfare

_________Global Strike

_________Missile Defense

_________Intelligence, Surveillance and Reconnaissance (ISR)

_________Combating Weapons of Mass Destruction

_________Analysis and Targeting

M. Please provide a detailed description of the work provided by the Contractor. This is extremely helpful to us in assessing the relevancy to our current acquisition. We appreciate your effort and assistance very much: (Feel free to copy and paste or provide the PWS as an Attachment):

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

Customer or agency name: ____________________________________

Geographic location of services under this contract: ____________________________________

SECTION 3: EVALUATOR IDENTIFICATION

Please provide information for primary individual completing this survey.

A. Evaluator’s Name/Title, Telephone Number, Mailing/e-mail Address:

B. Relationship to Contract: ___________________________________

SECTION 4: EVALUATION

A. 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:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL (E) – Performance meets contractual requirements and exceeds 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.

V VERY GOOD (V) – Performance meets contractual requirements and exceeds 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.

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

M MARGINAL (M) – Performance does 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.

U UNSATISFACTORY (U) – Performance does 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.

N NOT APPLICABLE (N) – Unable to provide a rating. Contract did not include performance on this element or sub-element, or information was not available. Do not know.

DISCLAMER: If the evaluations provided conflict with CPARS, CPARS will take precedence over individual evaluations.

B. For each question, please place an “X” in the box corresponding to the rating. Please provide supporting rationale for all ratings except “Satisfactory” or “Not Applicable”. The narratives need not be lengthy, just clear and concise. Space for narrative comments is provided at the bottom of the questionnaire. If more space is needed, use the back of the questionnaire or attach additional pages.

CONTRACT/PAST PERFORMANCE INFORMATION QUESTIONNAIRE:

*Past Performance References shall address at least one of the A&AS definitional subdivisions

PROGRAM MANAGEMENT E V S M U N

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 Government staff

(including the ability to successfully resolve disagreements/disputes)

P3. Timeliness/effectiveness of contract problem resolution without extensive customer guidance

P4. Understood/complied with customer objectives and technical requirements

P5. Successfully responded to emergency and/or surge situations

P6. Resolution of Organizational Conflicts of Interest (OCI)

P7. Responsiveness in providing timely and realistic proposals with accurate cost estimates for both awards and modifications

P8. Provided corporate expertise and reach back capabilities

P9. Ability of Contractor to: attract, recruit, hire, train and retain qualified management and technical personnel to accomplish mission requirements;

manage subcontractors to include identification and resolution of subcontractor problems; ensure continuation of services during personnel absences or vacancies; replace/fill vacancies within timeframe specified; maintain training/certification currency

TECHNICAL REQUIREMENTS E V S M U N

T1. Quality of service in A&AS Studies, Analyses and Evaluations*

T2. Quality of service in A&AS Engineering and Technical Services*

T3. Quality of service in A&AS Management and Professional Support

Services*

T4. Quality/accuracy/integrity of technical data/reports

T5. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements

T6. How well did contractor meet technical requirements in Section 1 L above:

NARRATIVE SUMMARY FOR ALL CONTRACTS

(DO NOT INCLUDE PERSONAL NAMES IN THE NARRATIVE SECTION.)

N1. What were the contractor’s greatest strengths in the performance of the contract?

N2. What were the contractor’s greatest weaknesses in the performance of the contract?

N3. Would you award another contract to this contractor?

N4. Comments on the above sections for Technical, Program Management, Cost Performance:

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

1. Do you know of any other contracts performed by this contractor? If yes, please provide the following contract information, if known:

a. Contract Number: _______________________________________________________

b. Contractor Name: ________________________________________________________

c. Type of Contract: ________________________________________________________

d. Status: Active Completed:________

e. Date of Award: __________________________________________________________

f. Contract Amount: ________________________________________________________

COST PERFORMANCE E V S M U N

C1. Accuracy in forecasting contract costs

C2. Ability to perform within contract costs

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

C4. Sufficiency and timeliness of cost reporting

C5. Ability to accurately invoice via Wide Area Workflow

OVERALL PERFORMANCE E V S M U N

O1. Overall performance rating

g. Contract Completion Date (Including Extensions): ______________________________

Thank you!

Please return this by e-mail to the Government POC, Eric Mahowald at eric.mahowald@offutt.af.mil and Jaimie

Haddock at jaimie.haddock@offutt.af.mil or (fax to 402-294-0430 /DSN 271-7280).

mailto:eric.mahowald@offutt.af.mil mailto:jaimie.haddock@offutt.af.mil