A23 Attachment 05 Past Performance Questionnaire R1.docx

ATTACHMENT 05

PAST PERFORMANCE QUESTIONNAIRE

SOURCE SELECTION SENSITIVE

This is a past performance questionnaire for Washington Headquarters Services (WHS) Acquisition Directorate to obtain past performance information on the contractor listed below. You should have received this questionnaire along with a Client Authorization Letter from the contractor listed below asking for your cooperation in completing this questionnaire.

Information obtained in this questionnaire is for the sole purpose of evaluating the contractor’s past performance history to assist WHS in determining best value for award of a contract resulting from our solicitation. As an evaluator of the contractor’s past performance, your participation in this questionnaire is greatly appreciated.

INSTRUCTIONS

To complete this questionnaire, the contractor should:

Complete the CONTRACT DATA section on Page 2

Forward this questionnaire along with a Client Authorization Letter to the reviewer.

To complete this questionnaire, the reviewer should:

1. Review the CONTRACT DATA section on Page 2.

Review and complete the ADMINISTRATIVE INFORMATION section on Page 2.

Complete the EVALUATION FACTORS section starting on Page 5 using the RATINGS on Pages 3-4 based on the Contractor Performance Rating System (CPARS).

Evaluate and assign a rating for Quality of Product or Service, Schedule, Cost Control, Management, Utilization of Small business, and Regulatory Compliance.

Include a narrative for each rating if appropriate.

Return the questionnaire by email to juan.c.gomez2.civ@mail.mil and kyle.r.blake5.civ@mail.mil by 9 July 2021 at 3:00 PM ET or the response date indicated for solicitation HQ003421R0003 on sam.gov.

QUESTIONS

If you have any questions about completing or submitting this questionnaire, please contact the Senior Contract Specialist for this acquisition: Juan Gomez at juan.c.gomez2.civ@mail.mil.

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND 3.104

Solicitation HQ003421R0003

Form Revision 1 – 17 Jun 2021

CONTRACT DATA

Contract Number:

Contractor Name:

Contract Title:

Contractor Address:

Contract Value:

Contractor DUNS:

Contract Type:

Contract Award Date:

Agency/Org. Name:

Reporting Period (Start):

Contracting Office:

Reporting Period (End):

TASK ORDER DATA (IF APPLICABLE)

Task Order Number:

Task Order Value:

Task Order Title:

Task Order Award Date:

Reporting Period (Start):

Task Order Type:

Reporting Period (End):

ADMINISTRATIVE DATA

Evaluator:

Contracting Officer:

Phone:

Phone:

Fax:

Fax:

Email:

Email:

Contractor Rep.:

Alt. Contractor Rep.:

Phone:

Phone:

Fax:

Fax:

Email:

Email:

(Next page)

RATINGS

The following ratings and definitions apply to the Quality, Schedule, Cost Control, Management, Utilization of Small Business and Regulatory Compliance factors:

EVALUATION FACTORS

1. Quality of Product or Service. Quality reflects the contractor’s management of the quality control program, as well as the quality of the work itself. Assess the Contractor's conformance to contract requirements, specifications and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

2. Schedule. Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance). This evaluation of the contractor’s adherence to the required delivery schedule should include the contractor’s efforts during the evaluation period that contribute to or affect the schedule variance. Also, address significance of scheduled events (e.g., design reviews), discuss causes, and assess the effectiveness of contractor corrective actions. This element applies to contract/order closeout activities as well as contract/order performance. Instances of adverse actions such as the evaluation of liquidated damages or issuance of Cure Notices, Show Cause Notices, and Delinquency Notices are indicators of problems which may have resulted in variance to the contract/order schedule and should, therefore, be noted in the evaluation.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

3. Cost Control (Not required for Firm Fixed Price or Firm Fixed Price with Economic Price Adjustment). Assess the contractor’s effectiveness in forecasting, managing, and controlling contract/order cost. If the contractor is experiencing cost growth or underrun, discuss the causes and contractor-proposed solutions for the cost overruns or underruns. For contracts/orders where task or contract sizing is based upon contractor-provided person hour estimates, the relationship of these estimates to ultimate task cost should be assessed. In addition, the extent to which the contractor demonstrates a sense of cost responsibility, through the efficient use of resources, in each work effort should be assessed.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

4. Management. Assess the integration and coordination of all activity needed to execute the contract/order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

5. Utilization of Small Business (Not applicable if contractor is a small business or if the contract did not require a Subcontracting Plan). Assess whether the contractor provided maximum practicable opportunity for Small Business (including Alaska Native Corporations (ANCs) and Indian Tribes) (including Small Disadvantaged Businesses (which also includes ANCs and Indian Tribes), Women Owned Small Businesses, HUBZone, Veteran Owned, Service Disabled Veteran Owned Small Business, and ANCs and Indian Tribes that are not Small Disadvantaged Businesses or Small Businesses) to participate in contract/order performance consistent with efficient performance of the contract/order.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

6. Regulatory Compliance (e.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments). Assess compliance with all terms and conditions in the contract/order relating to applicable regulations and codes, using the Evaluation Ratings Definitions above. Consider aspects of performance such as compliance with financial, environmental (example: Clean Air Act, Clean Water Act), safety, and labor regulations as well as any other reporting requirements in the contract terms and conditions.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory