HHM40219R0007_Past_Performance_Questionnaire_for_References.docx

For Official Use Only/Source Selection Information – See FAR 2.101 and 3.104

PAST PERFORMANCE QUESTIONNAIRE TEMPLATE

HOW TO USE THIS TEMPLATE:

DIA contracting professionals are to use this template to create a Past Performance Questionnaire package to be included in a Solicitation that uses competitive procedures. The purpose of the Questionnaire is to obtain past performance information from the corresponding “Reference” government contracting offices of each Offeror, provided, those References do NOT submit their Contractor Performance Assessment Reports (CPARs) to the Past Performance Information Retrieval System (PPIRS) in accordance with FAR 42.15. (Otherwise, a Reference’s latest CPAR, and others, for the Offeror can be retrieved on-line directly from PPIRS, as needed.) This information is to be used in the source selection process, as appropriate.

TO FINALIZE THIS DOCUMENT:

Compose a Past Performance Questionnaire package for each Offeror to send to its “Reference” government contracting offices. References are to send the completed Questionnaire directly to you as the VaCA contact, not through the Offeror.

To produce a Questionnaire package from this template:

1. Select a unique file name and save the document file on your computer.

2. Remove each ‘< >’ marker, replacing each one with the insertion of the corresponding relevant information.

3. Remove this introductory page from the document before saving the final version of the Questionnaire package.

PAST PERFORMANCE QUESTIONNAIRE

FOR SOLICITATION HHM402-19-R-0007 A2RPMO for PP&E

To Offeror:

Please provide this Past Performance Questionnaire package to each of your “Reference” government contracting offices according to the instructions in Section L of the Solicitation.

To Offeror’s Reference:

The Virginia Contracting Activity (VaCA) requests your assistance in providing past performance information on the Contractor (a prospective “Offeror” 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 do not actually enter your CPARs into the Contractor Performance Assessment Report System (CPARS) or the Past Performance Information Retrieval System (PPIRS).

NOTE: If your office enters its CPARs into CPARS or PPIRS, please so advise the VaCA contact to that effect rather than completing this Questionnaire. This will enable VaCA to retrieve your latest CPAR for the Offer on-line from CPARS or PPIRS directly.

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 performance on your contract.

3. Please send a copy of the completed Questionnaire directly to the VaCA Contact by e-mail no later than 1000 hrs EST, 25 January 2019, for RFP HHM402-19-R-0007 A2RPMO for PP&E VaCA Contact: Mr. John “JT” Nolan Contract Specialist

Thank you for your time and support.

RATING INSTRUCTION

Please provide your assessment of each 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.

1. Rating Scale (Used for all factors except the “Utilization of Small Business” factor):

· Excellent - Performance meets contractual requirements and exceeds many requirements to the Government’s benefit.

· Good - Performance meets contractual requirements and exceeds some to the Government'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 corrective 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 Applicable (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 of your Office of Small Business Programs to make this assessment.)

· Excellent – Exceeded all negotiated subcontracting goals or exceeded at least one goal and met all of the other negotiated subcontracting goals.

· Good – Met all of the 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 of the 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 Applicable (N/A) - Unable to provide a score. Performance in this area not applicable to effort assessed.

PAST PERFORMANCE QUESTIONNAIRE

FOR SOLICITATION HHM402-19-R-0007, A2RPMO for PP&E

-- TO BE COMPLETED BY THE OFFEROR’S (CONTRACTOR’S) REFERENCE --

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

|_| Negotiated |_| Competitive |_| Non-Competitive

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

14. Key Subcontractors (list as needed):

· Subcontracting under this contract is covered by a [comprehensive][commercial][N/A] (select one) small business subcontracting plan.

· Date of latest Subcontracting Report/Summary Subcontracting Report: ___________

FACTORS RATED:

1. Quality of Product or Service – Assess the contractor's conformance to contract requirements, specifications, quality of software product and development, and standards of good workmanship (e.g., commonly accepted technical, professional standards).

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

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

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Cost Control – Assess the contractor’s effectiveness in forecasting, managing, and controlling contract cost, including reporting and analyzing variances.

Note: This factor is not rated for firm fixedprice, firm fixedprice with economic price adjustment, or firm fixedprice levelofeffort type contracts.

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Business Relations – Assess the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness, and quality of problem identification, corrective action plans, proposal submittals, the contractor's history of reasonable and cooperative behavior, customer satisfaction, timely award and management of subcontracts. Include the adequacy of the contractor’s accounting, billing, and estimating systems and the contractor’s management of Property in Possession of Contractor (PIPC) also known as Government Furnished Property/Equipment (GFP/GFE). Address the timeliness of awards to subcontractors and management of subcontractors, including subcontractor costs.

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5.

Problem Resolution (Management of Key Personnel) – 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 of reasonable and cooperative behavior, and customer satisfaction.

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. Utilization of Small Business – Assess the contractor's success with timely award and management of subcontracts, including whether the contractor met or exceeded small business, small disadvantaged business, small business HUBZone, veteran-owned small business, service disabled veteran-owned small business, and women-owned small business participation and subcontracting goals.

Note: This factor is rated only if FAR 52.219-9 is stated in the award and the contractor is other than a small business.

|_| Excellent |_| Good |_| Fair |_| Poor |_| Unsatisfactory |_| N/A Comments:________________________________________________________________________________________________________________________________________________________________________________________________________________________

OTHER AREAS ASSESSED:

1. Has the contractor been given cure notice(s), show cause notices(s), suspension of progress payments, or letters of direction, etc.?

|_| Yes |_| No |_| N/A Comments:__________________________________________________________________

2. Do you intend to exercise the option on this contract?

|_| Yes |_| No |_| N/A Comments:__________________________________________________________________

3. Recommendation: Given what you know today about the contractor’s ability to execute what they promised in the proposal, would you award to them today if you had a choice?

|_| Yes |_| No Comments:__________________________________________________________________

4. Please provide any additional comments concerning the past performance of the contractor.

Comments:__________________________________________________________________