EXHIBIT_3_PP_Questionnaire.docx

EXHIBIT 3

PAST PERFORMANCE QUESTIONNAIRE

PSYCHOLOGICAL ASSESSMENT SUPPORT

H92239-15-R-0002

RETURN YOUR COMPLETED QUESTIONNAIRE TO, HQ UNITED STATES ARMY SPECIAL OPERATION COMMAND, DCSC, BLDG E2929 DESERT STORM DRIVE, , ATTN: Valaida J. Bradford, Contracting Officer, EMAIL: USASOC.CONTRACTING4@SOC.MIL

FAX (910)432-9345.

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SENSITIVE AND SHALL NOT BE RELEASED TO THE OFFEROR.

Part I. CONTRACTOR INFORMATION (To be completed by the contractor prior to mailing or faxing to respondent):

Contractor Name and Address: _________________________________________________________________________________________

Point of Contact: _________________________________________________________________________________________

Description/Explanation of Services Provided: _________________________________________________________________________________________

Contractor’s Role in the Program: _____Prime _____Subcontractor _____Vendor/Supplier

Contract Number: ________________________________Number of Years: Basic: ________ Option:______

Contract Type(s): List all applicable contract types, i.e. Firm-Fixed-Price, Time & Materials, Cost, etc.______________________________________________________________________________________

RESPONDENT INFORMATION (To be completed by respondent, i.e., Commercial Sector or Government):

Name/Signature and Role Relative to Contract (e.g. Buyer, Program Manager):_________________________________________________________________________________

Agency or Business: _________________________________________________________________________________________

Address: _________________________________________________________________________________________

Telephone No. ______________________________

FAX No. ___________________________________

PART II. GENERAL PROGRAM INFORMATION.

Period of Performance:

1. Original Schedule (assuming all options exercised): Beginning Date _________ through ____________

Contract Dollar Value:

3. Primary Causes of Changes: __________________________________________________________________________________________________________________________________________________________________________________

NOTE: In Part III, should your response be other than “satisfactory,” please provide supporting documentation in “Additional Remarks” on page 3 of 4.

PART III. PERFORMANCE ASSESSMENTS.

Please check the appropriate rating for each of the following questions:

N/A=Not Applicable U=Unsatisfactory M=Marginal S=Satisfactory V=Very Good E=Exceptional

1. The Contractor is committed to customer satisfaction.

2. The contractor has the necessary manpower to perform during the initial start-up period and has performed in an efficient and timely manner.

3. The contractor is capable, efficient, and effective.

4. Provided all reports required by the contract in a timely manner.

5. Identified problems in advance and when necessary, took positive and effective corrective actions.

6. Responded timely and professionally in performing emergency responses.

7. Met the terms of the contract and within the contractual price.

8. Contractor provided effective Quality Control/Inspection procedures.

9. Responsive to the contract performance by identifying, correcting, and preventing initial and recurring contract discrepancies.

10. The contractor did safeguard, track, and account for Government Furnished Property.

11. The contract manager does have sufficient authority to make decisions and take actions necessary to ensure services were performed.

12. Select one rating which most accurately describes the contractor’s overall performance on your contract.

13. Has action been initiated to cancel or terminate the contract for default? If yes, explain. _________________________________________________________________________________________

14. Have there been any disputes/claims relative to the contract? If yes, explain.

15. Describe the contractor’s or company’s strong and/or weak points identified as a result of technical performance and any technical performance risk identified during the life of the contract. _________________________________________________________________________________________

16. If given a choice, would you award to this contractor again? If not, please explain. __________________________________________________________________________________________________________________________________________________________________________________

17. Additional Remarks.