J.6_Past_Performance_Substitute_HCaTS_Un-Editable_19_May.pdf

Past Performance Substitute Form Human Capital and Training Solutions (HCaTS)

Solicitation # GS02Q15CRR0001 Amendment # 00 Section J.6

The Government may contact you to verify or clarify the information provided on this form.

This form is for the evaluation of past performance purposes only. This form shall only be used for all Non- US Federal and/or US Federal contracts, task orders or purchase orders that do not have past performance information in the CPARS or PPIRS databases to report on the Contractor that was awarded the contract, task order or purchase order. The Assessing Official shall be an employee of either the Contracting Entity or Customer/Client Organization who has direct knowledge of the contract, task order or purchase order and be authorized to provide the rating. For US Federal contracts, task orders or purchase orders, the Assessing Official shall be a Federal government employee. If the Contractor performed work on the contract, task order or purchase order as a First-Tier Subcontractor, the Assessing Official shall be an employee of the Prime Contractor who has direct knowledge and is authorized to provide the rating.

The Government will use this information for source selection purposes under the Human Capital and Training Solutions (HCaTS) solicitation. If you have any questions about this document, please email hcats@gsa.gov.

(Read all instructions carefully before completing this form) General Instructions For the purpose of completing this form:

- The term "Contractor" means the company who was awarded the contract, task order or purchase order and is submitting this form for its past performance evaluation.

- To fill this form, place the cursor in the highlighted area and begin typing. After completing this form, you must save this document to your computer as a pdf file and name it in accordance with Section L.4.1.

Section I. Company Information Instructions This section is to provide general information about the Contractor.

Section II. Contract Information Instructions This section requires information regarding the contract, task order or purchase order performed by the Contractor. Provide the following information to complete this section:

a. Contract/Task Order/Purchase Order/Project Number: The Contract Number, Task Order, Purchase

Order or Project Number.

b. Task Order Number: For a collection of task orders, provide up to six Task Order numbers under the same project number. Leave blank, if only evaluating one contract, task order or purchase order.

c. Termination Type: If the contract has been terminated before completion, select one of the following:

1. Termination for Default or Cause: The Contractor failed or was determined to be incapable to complete the contract/project.

2. Termination for Convenience: The contract/project was terminated for other than the Contractor's fault.

d. Check only one of the NAICS Codes if it best describes the service(s) provided under the contract, task order or purchase order specified in Section II-A. To review NAICS Codes descriptions, visit http:// www.census.gov/eos/www/naics/ The North American Industry Classification System (NAICS) is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the US business economy.

If the contract, task order or purchase order was awarded by the Federal government, this section shall only be filled out if the Assessing Official is a duly warranted Contracting Officer, otherwise this section shall be left blank.

http://www.census.gov/eos/www/naics/ http://www.census.gov/eos/www/naics/

Solicitation # GS02Q15CRR0001 Amendment # 00 Section J.6

The Government may contact you to verify or clarify the information provided on this form.

Section III. Evaluation Instructions For Blocks A through F, choose from one of the following ratings from drop-down list:

EXCEPTIONAL, VERY GOOD, SATISFACTORY, MARGINAL, UNSATISFACTORY, or N/A.

Note that this rating system is subjective and depends on your experience with the Contractor. For each part, at the minimum consider the following areas:

Quality – In part, assess the contractor’s conformance to contract/order requirements, specifications and standards of good workmanship (e.g., commonly accepted technical and professional standards). Include, as applicable, information on the following: Are reports/data accurate? Does the product or service provided meet the specifications of the contract/order? Does the contractor’s work measure up to commonly accepted technical or professional standards? What degree of Government technical direction was required to solve problems that arise during performance?

Schedule – Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Cost Control – (Not required for Fixed Price type contracts/orders). Assess the contractor’s effectiveness in forecasting, managing, and controlling contract/order cost. If the contractor is experiencing cost growth or under-run, discuss the causes and contractor-proposed solutions for the cost overruns or under-runs. For contracts/orders where task or contract sizing is based upon contractor-provided person hour estimates, the relationship of these estimates to ultimate task cost should be assessed. In addition, the extent to which the contractor demonstrates a sense of cost responsibility, through the efficient use of resources, in each work effort should be assessed.

Management – Assess the integration and coordination of all activity needed to execute the contract/order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Utilization of Small Business – FAR Subpart 19.7 and 15 U.S.C. 637 contains statutory requirements for complying with the Small Business Subcontracting Program. Assess whether the contractor provided maximum practicable opportunity for Small Business (including Alaska Native Corporations (ANCs) and Indian Tribes) (including Small Disadvantaged Businesses (which also includes ANCs and Indian Tribes), Women Owned Small Businesses, HUBZone, Veteran Owned, Service Disabled Veteran Owned Small Business, and ANCs and Indian Tribes that are not Small Disadvantaged Businesses or Small Businesses) to participate in contract/order performance consistent with efficient performance of the contract/order.

Regulatory Compliance – Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes. Consider aspects of performance such as compliance with financial, environmental (example: Clean Air Act, Clean Water Act), safety, and labor regulations as well as any other reporting requirements in the contract.

The following definitions apply to: Quality, Schedule, Cost Control, Management, and Regulatory Compliance.

EXCEPTIONAL Performance meets contractual requirements and exceeds many to the Government’s/ Customer's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD Performance meets contractual requirements and exceeds some to the Government’s/ Customer's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Solicitation # GS02Q15CRR0001 Amendment # 00 Section J.6

The Government may contact you to verify or clarify the information provided on this form.

SATISFACTORY 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.

MARGINAL Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated 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.

UNSATISFACTORYPerformance 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/A

(NOT APPLICABLE)

N/A (Not Applicable) should be used if the ratings are not going to be applied to a particular area for evaluation.

The following definitions apply to Utilization of Small Business:

EXCEPTIONAL Exceeded all statutory goals or goals as negotiated. Had exceptional success with initiatives to assist, promote, and utilize small business (SB), small disadvantaged business (SDB), women-owned small business (WOSB), HUBZone small business, veteran-owned small business (VOSB) and service disabled veteran owned small business (SDVOSB). Complied with FAR 52.219-8, Utilization of Small Business Concerns. Exceeded any other small business participation requirements incorporated in the contract/order, including the use of small businesses in mission critical aspects of the program. Went above and beyond the required elements of the subcontracting plan and other small business requirements of the contract/order. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner.

VERY GOOD Met all of the statutory goals or goals as negotiated. Had significant success with initiatives to assist, promote and utilize SB, SDB, WOSB, HUBZone, VOSB, and SDVOSB. Complied with FAR 52.219-8, Utilization of Small Business Concerns. Met or exceeded any other small business participation requirements incorporated in the contract/order, including the use of small businesses in mission critical aspects of the program. Endeavored to go above and beyond the required elements of the subcontracting plan. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner.

SATISFACTORY Demonstrated a good faith effort to meet all of the negotiated subcontracting goals in the various socio-economic categories for the current period. Complied with FAR 52.219-8, Utilization of Small Business Concerns. Met any other small business participation requirements included in the contract/ order. Fulfilled the requirements of the subcontracting plan included in the contract/order. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner.

MARGINAL Deficient in meeting key subcontracting plan elements. Deficient in complying with FAR 52.219-8, Utilization of Small Business Concerns, and any other small business participation requirements in the contract/order. Did not submit Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate or timely manner. Failed to satisfy one or more requirements of a corrective action plan currently in place; however, does show an interest in bringing performance to a satisfactory level and has demonstrated a commitment to apply the necessary resources to do so. Required a corrective action plan.

UNSATISFACTORYNon-compliant with FAR 52.219-8 and 52.219-9, and any other small business participation requirements in the contract/order. Did not submit Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate or timely manner. Showed little interest in bringing performance to a satisfactory level or is generally uncooperative. Required a corrective action plan.

N/A

(NOT APPLICABLE)

N/A (Not Applicable) should be used if the ratings are not going to be applied to a particular area for evaluation.

Solicitation # GS02Q15CRR0001 Amendment # 00 Section J.6

The Government may contact you to verify or clarify the information provided on this form.

(Place the cursor in the highlighted area and begin typing)

SECTION I. COMPANY INFORMATION

Type your answer for this section regarding the Contractor:

Company Name Division Name (if applicable) DUNS Number

Address (Street, City, State, Zip Code, Country)

SECTION II. CONTRACT INFORMATION

Type your answer for this section regarding the contract/project:

A. Contract/Task Order/Purchase Order/Project Number B. Termination Type C. Task Order Numbers (up to six):

D. Check one of the following that best describes the contract/project in Section II-A:

541611 (Administrative Management and General Management Consulting Services) 541612 (Human Resources Consulting Services) 541613 (Marketing Consulting Services) 541618 (Other Management Consulting Services) 611430 (Professional and Management Development Training) 611699 (All Other Miscellaneous Schools and Instruction) 611710 (Educational Support Services) 624310 (Vocational Rehabilitation Services) None of the above

TO#1:

TO#2:

TO#3:

TO#4:

TO#5:

TO#6:

SECTION III. EVALUATION AREAS

To complete this section, refer to instruction for Section III to choose the applicable rating:

A. Quality B. Schedule C. Cost Control

D. Management E. Utilization of Small Business F. Regulatory Compliance

SECTION IV. ASSESSING OFFICIAL

This form shall be signed by an Assessing Official with direct knowledge or observation of the Contractor's past performance. By signing below, I certify that the information provided in this form is accurate to the best of my knowledge and believe it to be true and correct.

Organization/Agency Name First Name, Last Name of Assessing Official

Email Address Phone Number Title

Address (City, State, Zip code, Country)

Signature (This form shall be signed with a certified digital-signature or ink-signature.) Date (mm/dd/yy)