J.2 - Past Performance Questionnaire.pdf

Attachment 2

PAST PERFORMANCE QUESTIONNAIRE

Requirement: Technical Support Services for communication systems upgrades to support the U.S.

Marine Corps (USMC) in Afghanistan.

RELEVANT PROJECT INFORMATION FACT SHEET

Provide a completed form for each requirement for which experience is being claimed

Company/Firm Name:

Project Name:

Project Location:

Were services provided on a firm-fixed-price contract (Y/N)? ____ If No, what type was it?

Role: Firm’s role on this effort as reported on this Project Experience form: [ ] Prime Contractor; or [ ] Subcontractor; or [ ] Team Partnering

Brief Description of requirement (Include, as applicable, how project is similar in scope to the work required in this proposal)

Contract Amount:________________________

Original Contract Completion Date:____________________________

Final Contract Completion Date: ________________________

Actual Completion Date: ________________________

Was the effort terminated early or were cure/show cause letters received? ___Yes ___No

Explain early termination (default/convenience) or cure/show cause letters

List and explain any customer concerns or dissatisfaction. Explain how you responded.

Client/Agency Point of Contact, name, address, fax and telephone number

Please check the level of the Contractor’s overall performance in each of the business management factors listed below.

Check “N/A” if the factor does not apply to the contract being rated. Please closely address those items in boldface.

LEVEL OF SATISFACTION

EVALUATION FACTOR Excellent Very Good

Good Fair* Poor

N/A

Quality, Accuracy & Timeliness of Required Documentation (submittals, bonds, insurance, schedules, etc.)

Identification & Reporting of Problems & Potential Problems

Communicating & Interfacing with Governments/Company Personnel

Compliance with Technical Contractual Terms and Conditions

Accommodates Fluctuating Workloads

Adherence to Safety Policies & Procedures

Success of Quality Control Program

Empowerment of Project Manager(s)/Supervisors

Quality & Stability of Key Personnel

Adherence to Service Contract Act

Overall Rating of the Contractor’s Performance

1. Were claims filed during contract performance?

YES ________ NO __________

2. Were monetary reductions assessed?

YES ________ NO __________ $________________

3. Would you award to this contractor again?

4. Would you recommend another contact for further information?

* Please comment on all Fair and Poor ratings given, or on any other ratings, as desired.

COMMENTS:

Original Contract Completion Date:____________________________