PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

SOURCE SELECTION INFORMATION IAW FAR 2.101 & 3.104

FOR OFFICIAL USE ONLY

The Defense Information Systems Agency (DISA) is in the process of selecting a contractor for the DISA Enterprise Voice Services contract.

One of the considerations in proposal evaluation is the verification of the Offerors' past and present performance on contracts, which reflect the Offeror's ability to perform on the proposed effort. We depend on information received from Agencies such as yours, which have had firsthand experience with an Offeror, for the evaluation of the Offeror's performance on those contracts.

Our areas of interest in the Offeror are summarized in the enclosed questionnaire. Your responses to the questionnaire is requested no later than the time of RFP Proposal Submission.

To assist you in preparing your response and expediting your reply, the questionnaire should be completed electronically and emailed to Contracting Specialist, Vivianna Diaz, vivianna.m.diaz.civ@mail.mil, and cc Contracting Officer, Adelis M. Rodriguez, adelis.m.rodriguez.civ@mail.mil.

Your completed questionnaire will be considered SOURCE SELECTION INFORMATION IAW FAR

2.101 & 3.104 and will become a part of the official contract file.

Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Respectfully, Adelis M. Rodriguez Contracting Officer

Attachment 5: Past Performance Questionnaire mailto:vivianna.m.civ@mail.mil mailto:adelis.m.rodriguez.civ@mail.mil

PAST PERFORMANCE QUESTIONNAIRE RATING SHEET

RATING SCALE

Please use the following ratings to answer the questions. If you are unable to rate an item because it was not a requirement, never an issue, or you have no knowledge of the item in question, then you should mark “NA”.

EVALUATION CRITERIA

EXCEPTIONAL (E) - Performance meets or met contractual requirements and exceeds or exceeded 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.

VERY GOOD (VG) - Performance meets or met contractual requirements and exceeds or exceeded 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.

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

MARGINAL (M) – Performance does not or did 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.

UNSATISFACTORY (U) – Performance does not or did 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.

NOT APPLICABLE (NA) - Unable to provide a score.

NOTE: For statements indicating “Unsatisfactory”, please provide a brief explanation in the comments section of the survey.

PAST PERFORMANCE QUESTIONNAIRE

SECTION I: CONTRACT IDENTIFICATION (To be filled out by Offeror)

1. CONTRACTOR’S NAME & ADDRESS:

2. CAGE CODE OF PRIME CONTRACTOR:

3. CONTRACT NUMBER (include task number if applicable):

4. AWARD ENVIRONMENT:

COMPETITIVE NON-COMPETITIVE

5. CONTRACT TYPE:

FIRM FIXED PRICE COST + FEE

FIXED PRICE + FEE LABOR HOUR

COST or COST SHARING TIME & MATERIALS

OTHER ___________________

6. PERIOD OF PERFORMANCE (including options):

7. INTIAL CONTRACT VALUE (including options):

8. CURRENT/FINAL CONTRACT VALUE

(including options):

9. REASONS FOR DIFFERENCES BETWEEN INITIAL CONTRACT VALUE AND FINAL CONTRACT VALUE:

10. DESCRIPTION OF PRODUCTS/SERVICE PROVIDED:

11. LOCATION SERVICES PROVIDED (local, nationwide, worldwide, etc.):

SECTION II. EVALUATOR AND AGENCY IDENTIFICATION (To be filled out by the Evaluator)

1. AGENCY (CUSTOMER) NAME:

2. EVALUATOR NAME & TITLE:

3. EVALUATOR CONTACT INFORMATION:

TEL NO.:

E-MAIL:

4. NUMBER OF YEARS EVALUATOR

WORKED ON SUBJECT CONTRACT:

CONTRACTOR PERFORMANCE EVALUATION SURVEY

Not Applicable

Unacceptable

Marginal

Satisfactory

Very Good

Exceptional

QUALITY OF PRODUCT OR SERVICE:

(1) The Contractor provided a product or service that conformed to contract requirements, specifications, and standards of good workmanship.

(2) The Contractor submitted accurate reports.

(3) The Contractor utilized personnel that were appropriate to the effort performed.

COST CONTROL:

(1) The Contractor performed the effort within the estimated cost/price.

(2) The Contractor submitted accurate invoices on a timely basis.

(3) The Contractor demonstrated cost efficiencies in performing the required effort.

(4) The actual costs/rates realized closely reflected the negotiated costs/rates.

SCHEDULE:

(1) The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract.

(2) The Contractor was responsive to technical and/or contractual direction.

MANAGEMENT:

(1) The Contractor demonstrated effective management over the effort performed.

(2) The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) and/or Technical Point of Contact (TPOC) were apprised of technical, cost, and schedule issues.

(3) The Contractor presented information and correspondence in a clear, concise, and businesslike manner.

(4) The Contractor promptly notified the COR, TPOC, and/or Contracting Officer in a timely manner regarding urgent

(5) The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical program

(6) The Contractor made timely award to, and demonstrated effective management of, its subcontractors.

(7) The Contractor demonstrated an effective small/small disadvantaged business subcontracting program.

REGULATORY COMPLIANCE

(1) Contractor’s efforts to comply with laws, rules, regulations, as required during performance of the contract

CUSTOMER SATISFACTION

(1) The products/services provided adequately met the needs of the program.

(2) The Contractor was able to perform with minimal or no direction from the COR or the

TPOC.

(3) I am satisfied with the performance of the Contractor under this effort.

ADDITIONAL COMMENTS

OVERALL RATING

EXCEPTIONAL

(E) (Blue)

VERY GOOD

(VG) (Purple)

SATISFACTORY

(S) (Green)

MARGINAL

(M) (Yellow)

UNSATISFACTORY

(U) (Red) Comments:

EVALUATOR’S SIGNATURE Date