HQ0858-21-R-0016_Attachment L-02 PPQ Form 07.22.2021.docx

Past Performance Questionnaire

Background: This questionnaire will be used to provide information to support the Missile Defense Agency Facilities Lifecycle Management (FLCM) services procurement, RFP HQ0858-21-R-0016.

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-FLCM@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)

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

V. Performance Evaluation

Planning and programming

Siting; Requirements Development and Design and Construction

Site activation and On-site operations

Sustainment

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.

Ability to recruit and retain qualified personnel

Ability to solve employee performance problems

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)

Compliance with contractual small business subcontracting goals

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:

Overall Rating (Technical and Management Combined)

VI. General Comments:

Assessor’s Signature Date

FOR SOURCE SELECTION INFORMATION – FAR 2.101 AND FAR 3.104 –

CONTROLLED UNCLASSIFIED INFORMATION (WHEN FILLED IN)

Approved for Public Release 21-MDA-10882 (11JUL2021)