SCIPIIIATCH2PastPerformance.pdf

HDEC03-11-R-0001 Section J – Attachment 2 1 30 Jun 2011

SECTION J – ATTACHMENT 2

Past Performance Questionnaire

30 June 2011

Solicitation: HDEC03-11-R-0001

Title: SCIP III MULTIPLE AWARD IDIQ

Past Performance Information and/or Questionnaires are due no later than:

Date: 15 AUG 11 Time: 4:00 P.M. (CST)

Contracting Office: Defense Commissary Agency 2250 Foulois Street Suite 3 Lackland AFB 78236

Contract Specialist: Mr. Derek Dansby derek.dansby@deca.mil

(210) 671-5283

Mrs. Tracy Blake tracy.blake@deca.mil

(210) 671-5271

Contract Officer: Mr. Terry Ward terry.ward@deca.mil

(210) 671-5877

HDEC03-11-R-0001 Section J – Attachment 2 2 30 Jun 2011

Suggested Request Letter

DDMMYY

TO: Insert addressee (Agency or Company who will complete the questionnaire on your behalf) Address City State, Zip Code

FROM: Your Firm Name Address City State, Zip Code

SUBJECT: Past Performance Information Request for Solicitation HDEC03-11-R-0001, SCIP III IDIQ at Lackland AFB, TX.

1. You have been identified as a Point of Contact (POC) for a past and/or present performance evaluation of YOUR FIRM. YOUR FIRM is currently being considered for an Indefinite Delivery, Indefinite Quantity (IDIQ), Firm-Fixed Price (FFP), Multiple Award Contract for the Defense Commissary Agency at Lackland AFB TX.

2. Your prompt attention to this Past Performance Questionnaire will be greatly appreciated. Please be sure to email (preferred method) or fax (210) 671-1196 the completed worksheet directly to the Contracting Specialists:

Mr. Derek Dansby Mrs. Tracy Blake derek.dansby@deca.mil tracy.blake@deca.mil

(210) 671-5283 (210) 671-5271

3. If you have any questions or concerns regarding this request, please contact Mr. Terry Ward, Contracting Officer at (210) 671-5877 or by email terry.ward@deca.mil

YOUR FIRM’S POC

Title

Attached

1. Past Performance Questionnaire, dated 30 Jun 2011

HDEC03-11-R-0001 Section J – Attachment 2 3 30 Jun 2011

SOURCE SELECTION SENSITIVE WHEN PAST PERFORMANCE QUESTIONNAIRE IS COMPLETED

NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS

P A S T P E R F O R M A N C E Q U E S T I O N N A I R E

SECTION A. Contractor Information (to be completed by the contractor requesting information)

1. Contractor’s name and address:

2. Contractor’s POC:

3. Phone: ( ) Fax: ( ) * Email:

4. Contract or Reference Number:

5. Project Title:

6. Description of Work:

7. Contract Type (examples): FFP – IDIQ – Cost-Reimbursement – Single – Multiple Award

8. Award Date: Scheduled Completion Date:

Current / Completion Date:

9. Project Award Amount: $ Current / Final Amount: $

10. Contractor being evaluated performed as the (choose): Prime Contractor Sub Contractor

11. Authorization is hereby granted to provide the information requested in Sections B and C of this Past Performance Questionnaire:

Signature ____________________________________ ____________ Name Date Title

HDEC03-11-R-0001 Section J – Attachment 2 4 30 Jun 2011

SOURCE SELECTION SENSITIVE WHEN PAST PERFORMANCE QUESTIONNAIRE IS COMPLETED

NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS

SECTION B. To be completed by a representative (respondent) responsible for current / past performance information in Section A of this document.

The following definitions are guidance in providing ratings:

E (Exceptional)

Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance of the element 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 of the element 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 of the element being assessed contains some minor problems for which corrective actions taken by the contractor were, or appear to be, satisfactory.

M (Marginal)

Performance does not meet some contractual requirements. The contractual performance of the element 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 of the element being assessed contains serious problem(s) for which the contractor’s corrective actions were, or appear to be, ineffective.

N/A (Not Applicable) Self-explanatory.

HDEC03-11-R-0001 Section J – Attachment 2 5 30 Jun 2011

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

Rate how the project that the Offeror developed for the user identified. Please place an “X” to indicate the rating for each area below. This information will be kept CONFIDENTIAL (please print or type):

1. Quality Control (QC): E V S M U N/A

a. Quality of Workmanship?

b. Adequacy of the QC Plan?

c. Implementation of the QC Plan?

d. Quality of the QC Document?

e. Storage of Materials?

f. Adequacy of Material?

g. Adequacy of Submittals?

h. Adequacy of QC Testing?

i. Adequacy of As-Builts?

j. Use of Specified Materials?

k. Identification/Corrections of Deficient Work in a Timely Manner?

Comments: ______________________________________________________________________________

2. Timely Performance: E V S M U N/A

a. Adequacy of Initial Progress Schedule?

b. Adherence to Approved Schedule?

c. Resolution of Delays?

d. Submission of Required Documentation?

e. Completion of Punchlist Items?

f. Submission of Updated and Revised Progress Schedules?

g. Warranty Response?

HDEC03-11-R-0001 Section J – Attachment 2 6 30 Jun 2011

3. Effectiveness of Management: E V S M U N/A

a. Cooperation and Responsiveness?

b. Management of Resources/Personnel?

c. Coordination and Control of Subcontractor(s)?

d. Adequacy of Site Clean-Up?

e. Effectiveness of Job-Site Supervision?

f. Compliance with Laws and Regulations?

g. Professional Conduct?

h. Review/Resolution of Subcontractor’s Issues?

i. Implementation of Subcontracting Plan?

4. Compliance with Labor Standards: E V S M U N/A

a. Correction of Noted Deficiencies?

b. Payrolls Properly Completed and Submitted?

c. Compliance with Labor Laws and Regulation with Specific Attention to the Davis-Bacon Act and EEO Requirements?

5. Compliance with Safety: E V S M U N/A

a. Adequacy of Safety Plan?

b. Implementation of Safety Plan?

c. Reporting/Correction of Noted Safety Deficiencies?

HDEC03-11-R-0001 Section J – Attachment 2 7 30 Jun 2011

6. Overall Rating: E V S M U N/A

a. Overall Rating for Contractor on this Project?

b. Would you award this Contractor any future contracts? YES

NO

SECTION C - RESPONDENT INFORMATION

Name / Title ______________________________________________________________________

Signature: _________________________________________ Date: ____________________

Agency/Company: _______________________________________________________________________

Address: ______________________________________________________________________________

Work phone number (including area code): ____________________________________________________

FAX number (including area code): __________________________________________________________

Your role relative to the project/contract: _____________________________________________________ (Administrative Contracting Officer, Inspector, Contract Administrator, Buyer, Quality Assurance Evaluator, Other - explain)

Length of involvement in project/contract: _____________________________________________________

Do you know anyone else who can provide information regarding this Offeror’s performance?

Name: ___________________________________ Phone/Fax: ___________________________________

Name: ___________________________________ Phone/Fax: ___________________________________

THANK YOU FOR YOUR ASSISTANCE IN COMPLETING THIS QUESTIONNAIRE