HQ0858-21-R-0010_Attachment L-02 PPQ Form R3 - 03.11.2021.pdf

HQ0858-21-R-0010

Attachment L-02

FOR SOURCE SELECTION INFORMATION – FAR 2.101 AND FAR 3.104 –

CONTROLLED UNCLASSIFIED INFORMATION (WHEN FILLED IN)

Past Performance Questionnaire

Background: This questionnaire will be used to provide information to support the Missile

Defense Agency Facilities, Logistics, and Environmental (FLE) services procurement, RFP

HQ0858-21-R-0010.

Message to the Assessor: Your feedback is requested by the Missile Defense Agency (MDA) to assist with establishing the performance history for the Contractor identified below. To expedite receipt of the requested information, MDA requests that you e-mail the completed questionnaire(s) to: laura.mabe@mda.mil AND TN-FLE@mda.mil. Your support and participation in this matter is essential and greatly appreciated!

Instructions for Offeror/Subcontractor and Assessor:

Sections I and II to be completed by the Offeror/ Subcontractor and provided to the Assessor (the

Government personnel that had experience with the Offeror/Subcontractor on a previous relevant contract). The assessor, in turn, to verify Sections I through II, complete the questionnaire, and submit to the Contracting Office.

Section II to be validated by the assessor. If any information is incorrect herein, please annotate and provide the correct information accordingly.

Sections III through VI to be completed in their entirety by the assessor.

I. Customer Identification Customer or Agency Name Customer or Agency Description Geographic Description of Services Under This Contract (i.e. single location, multiple locations, CONUS (in U.S.), or OCONUS (Outside U.S.)

II. Current or Historical Contract Identification

Contractor Name/Address

Contract Number:

Email:

Contract Type:

Initial Period of Performance:

Current/Final Period of Performance:

Initial Contract Value (base only):

Current/final Contract Value (base and exercised options only):

Reason if Initial Contract Value and

Current/final Contract Value above are different.

Brief description of services provided

Contractor Role (Prime or Subcontractor)

Approved for Public Release 21-MDA-10725 (4 Mar 21) mailto:FLE@mda.mil

FOR SOURCE SELECTION INFORMATION – FAR 2.101 AND FAR 3.104 –

CONTROLLED UNCLASSIFIED INFORMATION (WHEN FILLED IN)

ASSESSOR: The inform submitted by the company above is: CORRECT ☐ OR INCORRECT ☐

III. Assessor Information Assessor Name Title Phone Number/Email Address Role (examples: PM/PCO/ACO/Contract Specialist/COR/Quality Assurance Specialist, etc.)

Assessor’s number of years working on contract

IV. Assessment Definitions

The following definitions should be used in your assessment of Contractor performance

PERFORMANCE

LEVEL

DESCRIPTION

EXCEPTIONAL (E) The contractor’s performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD (VG) The contractor’s performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY (S) The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL (M) Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated 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 meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

NOT APPLICABLE

(N)

Unable to provide a score

Approved for Public Release

FOR SOURCE SELECTION INFORMATION – FAR 2.101 AND FAR 3.104 –

CONTROLLED UNCLASSIFIED INFORMATION (WHEN FILLED IN)

V. Performance Evaluation

Mission Capabilities E V

G

S M U N

Experience in Facility Operations and Sustainment Planning.

Experience in Procurement Management and Database

Management.

Experience in Product Support Management.

Experience in Supply Support/Property Accountability.

Experience in National Environmental Policy Act (NEPA).

Experience in Environmental Permitting.

Please provide rationale for the assigned ratings:

All comments are appreciated; however, at a minimum, rationale must be provided for exceptional

(E) or Unsatisfactory (U) ratings.

Management E V

G

S M U N

Provide Qualified Personnel

Responsiveness (cooperative behavior, teamwork, and customer satisfaction)

Program Management (effective coordination and integration of all activities)

Dispersed Locations (management of personnel in multiple/dispersed locations)

Cost Control (ability to forecast, manage, and control costs)

FOR SOURCE SELECTION INFORMATION – FAR 2.101 AND FAR 3.104 –

CONTROLLED UNCLASSIFIED INFORMATION (WHEN FILLED IN)

Please provide rationale for the assigned ratings:

All comments are appreciated; however, at a minimum, rationale must be provided for exceptional

(E) or Unsatisfactory (U) ratings.

Overall Rating of Contractor’s performance (Technical and Management) on contract being assessed:

E V

G

S M U N

Overall Rating (Technical and Management Combined)

VI. General Comments:

Assessor’s Signature Date