HHM402-13-R-0023_L-1_PAST_PERFORMANCE_QUESTIONNAIRE.pdf

ATTACHMENT L-I

PAST PD,RFORMANCE QUESTIONNAIRE

FOR SOLICITATION IIHM4O2-13-R.0023.

Tf,CHMCAL EXPLOITATION SUPPORT SERVICES

To Offeror:

Please provide this Past Performance Questionnaire package to each ofyour "Reference" government contracting olfices according to the instructions in Section L ofthe Solicitation.

To Offero r's Refere nce :

The Virginia Contracting Activity (VaCA) requests your assistance in providing past performance information on tlle Contractor (a prospective "OfferoC' under our Solicitation) and corresponding contract listed herein. Please complete this Questionnaire in accordance with the Instructions set forth immediately below.

VaCA agrees to protect your information as For Official Use Only/Source Selection Information consistent with FAR 2.101 and 3.104, as noted in the header on each page of this Questionnaire package.

Instructions for Offeror's Reference;

1. Please complete the attached Past Performance Questionnaire regarding the Offeror based upon your most recent Contractor Performance Assessment Report (CPAR) prepared in accordance with FAR 42.15; provided, you d@llactually enter your CPARs into the Contractor Performance Assessment Report System (CPARS) or the Past Performance Information Retrieval

2. Please use the attached Rating Instruction (or the equivalent you use in producing your CPARs) in providing the rating assessments that best describe the contractor's perfoffnance on your contract.

3. Please send a copy ofthe completed Questionnaire directly to the VaCA Contact by e-mail (preferred) or facsimile so as to be received timely no later than l2:00 PM EST (NOON) on Monday 29 April 2013.

VaCA Contact:

Contact E-mail Address:

Contact Phone Number:

Contact Fax Number:

Quentin McCoy quentin.mccoy@dodiis.mil

703-275-8600

703-275-8s58

NOTE: lf your of fice enters its CPARs into CPARS or PPIRS, plcasc so advisc thc VaCA contact to that effect rather than completing this Questionnairc. Thiswill cnable VaCA to retrieve your latest CPAR for the Offer on-line from CPAIIS or I'P ll{S directly.

RATING INSTRUCTION

Please provide your assessment ofeach factor rated in the Questionnaire by using the following rating scale and corresponding definitions (or the equivalent you use in producing your Contractor Performance Assessment Reports (CPARs)), as may be appropriate in each case.

I . Ratine Scale (Used for all factors except the "Utilization of Small Business" factor):

. Excellent - Performance meets contractual requirements and exceeds many requirements to the Govemment's benefit.

. Good - Performance meets contractual requirements and exceeds some to the Govemment's benefit.

. Fair - Performance meets contractual requirements.

. Poor - Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet implemented satisfactory conective actions.

. Unsatisfactory - Performance does not meet contractual requirements and recovery is not likely in a timely manner. Contractor's corrective actions to date are ineffective .

. Not Aoolicable (N/A) - Unable to provide a score. Performance in this area not applicable to effort assessed.

2. Rating Scale: (Used only for the "Utilization of Small Business" factor. Please seek the assistance ofyour Office of Small Business Programs to make this assessment.)

. Excellent - Exceeded all negotiated subcontracting goals or exceeded at least one goal and met all ofthe other negotiated subcontracting goals.

. Good - Met all ofthe negotiated subcontracting goals in the traditional socio-economic categories (SB, SDB and WOSB) and met at least one of the other socio-economic goals (HUBZone, VOSB, SDVOSB).

. Fair - Demonstrated a good faith effort to meet all ofthe negotiated subcontracting goals.

. Poor - Deficient in meeting key subcontracting plan elements. Deficient in complying with FAR 52.219-8 and any other small business participation requirements in the contract.

. Unsatisfactory -Noncompliant with FAR 52.219-8 and 52.219-9, DFARS 252.219-7003 (deviation) and any other small business participation requirements in the contract.

. Not Aoolicable (N/A) - Unable to provide a score. Performance in this area not applicable to effort assessed.

PAST PERFORMANCE QUESTIONNAIRE

FOR SOLICITATION HHM4O2-I3-R-M8.

TECIINICAL EXPLOITATION SI'PFORT SERVICES

-- TO BE COMPLETED BY THE OFFEROR'S (CONTRACTOR'S)

REFERENCE --

I . Offeror (Contractor/Division :

Street Address:

City, State, Zip:

Province/Country

CAGE Code:

DUNS + 4 Number:

FSC :

NAICS Code:

2. Report Type:

3. Period Assessed:

4. Contract #: Order #:

DoD Business Sector & Sub-sector:

5. Location of Contractor Performance:

6. ReferenceContracting Oflice./Code:

7. Contacting Officer (Name/Phone):

8. Contract Award Date/Effective Date:

9. Contract Comoletion Date.

| 0. Contract Awarded Dollar Value:

I l. Contract Current Dollar Value:

12. Basis for Contract Award (check all that apply):

! Negotiated ! Competitive ! Non-Competitive

13. Type of Contract (check the one that applies):

! Firm Fixed Price (FFP) [ Cost Plus Fixed Fee (CPFF)

! FFP (Level of Effort) ! Cpnn (Level of Effort)

! Time and Material I Labor Hour ! other:

14. Key Subcontractors (list as needed):

Subcontractor Name:

CAGE Code:

DUNS + 4:

Effort Performed:

15. Program Title & Acquisition Phase:

16. Contract Effort Descriotion:

o Does this contract include a subcontracting plan? [ ves ! No E N/A o Subcontracting under this contract is covered by a

[comprehensivel [commercial] [N4Al (select one) small business subcontracting plan.

. Date of latest Subcontracting Report/Summary Subcontracting Report:

FACTORSRATED:

l. Oaalitv of Prudact or Semice - Assess the contractot's conformance to contract requirements, specifications, quality ofsoftware product and development, and standards of good workmanship (e.9., commonly accepted technical, professional standards).

! Excellent ! Good ! rair ! poor ! Unsatisfactory n Vn Comments:

2, Timeliness (Schedule Peformancd - Assess the contractor's timeliness against the completion ofthe contract, task orders, milestones, delivery schedules, and administrative requirements (e.&, efforts that contribute to or effect the schedule variance).

! Excellent ! Good ! fair ! eoor ! Unsatisfactory n Nla Comments:

3. Cost Contrp!- Assess the contractor's effectiveness in forecastin& managing, and controlling contract cost, including reporting and analyzing variances.

!{9!9; This factor is not rated for firm fixed-price, firm fixed-price with economic price adjustment, or firm fixed-price level-of-effort type contracts.

E Excellent n Good ! rair ! poor ! Unsatisfactory [ Nle Comments:

4. Business Relations - Assess the integration and coordination ofall activity needed to execute the contract, specifically the timeliness, completeness, and quality of problem identification, corrective action plans, proposal submittals, the conhactor's history ofreasonable and cooperative behavior, customer satisfaction, timely award and management ofsubcontracts.

Include the adequacy ofthe contractor's accounting, billing, and estimating systems and the contractor's management ofProperty in Possession ofContractor (PIPC) also krown as Govemment Furnished Property/Equiprnent (GFP/GFE). Address the timeliness of awards to subcontractors and management of subcontractors, including subconhactor costs.

! Excellent n Cood ! pair I eoor ! Unsarisfactory E N/A Commenls:

5. Problcm Resolatian (Manasemenl of Kev PersonneU - Assess the completeness, timeliness, and quality of problem identification, corrective action plans, proposal submittals (especially responses to change orders, engineering changes proposals, or other undefinitized contract actions). The contractor's performance in selecting, retaining, supporting and replacing, when necessary, key personnel. The contractor's history ofreasonable and cooperative behavior, and customer satisfaction.

! Excellent ! Good ! rair ! Poor ! Unsatisfactory ! Wa Comments:

OTHER AREAS ASSESSED:

L Has lhe contactor been given c re notice(s), show caase nolices(s), suspensitn ofprogrcss palments, or lelten of dbection, etc,?

lYes nNo lve Comments:

2. Do you intend to sercise ,he option on this conlract?

! Yes lNo lNrn Comments:

3. Recommendatian: Given what you knoht today aboal the contructor's abiliut to etecute n hat the! pmmised in the pruposal, would you award to them today tr yoa had a choice?

[ves lxo Comments:

4. Please provide any additianal comments conceming the post perfomance of the conlraclon

Comments: