Exhibit_8-_H92239-15-R-0003_PP_Questionnaire.docx

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Joint Special Operations Medical Training(JSOMTC) Support
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H92239-15-R-0003
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PAST PERFORMANCE EVALUATION QUESTIONNAIRE

H92239-15-R-0003 – Exhibit 8

RETURN YOUR COMPLETED QUESTIONNAIRE TO DCSAC, UNITED STATES ARMY SPECIAL OPERATION COMMAND, ATTN: Brittany Black, Contract Specialist, EMAIL brittany.c.black@soc.mil or 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 ____________

2. Current Schedule (assuming all options exercised): Beginning Date _________ through ____________
3. Reason for difference (if applicable) ___________________________________________________________________________________

Contract Dollar Value:

1. Original Contract Amount (assuming all options exercised):________________________________________________________
2. Current Contract Value (assuming all options exercised): ________________________________________________________________
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

N/A
U
M
S
V
E

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.

ASSESSMENT RATING SYSTEM

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

NOTICE TO QUESTIONNAIRE RESPONDENTS: Please do not transmit this page when faxing your input to the name/address listed on page 1.

Source Selection Sensitive (FAR 2.101 & 3.104) – When Completed Page 1

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