PAST_PERFORMANCE_QUESTIONNAIRE.docx

PAST PERFORMANCE QUESTIONNAIRE

Section J, Attachment 2 Past Performance Questionnaire Form

1. GENERAL INSTRUCTIONS:

The offeror shall complete Part I of the Past Performance Questionnaire and e-mail the questionnaire to both the Government contracting activity and technical representative responsible for the past/current contract. The POCs shall electronically complete Part II of the questionnaire and e-mail the entire questionnaire to the Contracting Office no later than proposal due date, to ashley.maddox@dss.mil, stephen.heath@dss.mil and dss.aqindustrybox@dss.mil with “PPQ for (insert prime offeror’s name and CAGE Code)” in the subject line of the e-mail.

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does.

This information, when filled in, shall be treated as Source Selection Sensitive in accordance with FAR 3.104-3 and shall not be disclosed to anyone outside the Government Source Selection Team.

2. DESCRIPTION OF THE CURRENT SOLICITATION:

This solicitation is for the Defense Security Service’s Program Support Services acquisition. This acquisition will provide program support services and a broad range of inter-related management and support requirements in support of the program management, resource allocation, and business operations for the DSS. The contractor shall provide the level of language transcription, translation, and interpretation services.

PART I: (To be completed by the Offeror)

3. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

a. Name:

b. Title:

c. Date:

d. Telephone Number:

e. Address:

f. E-mail Address:

4. CONTRACT IDENTIFICATION

a. Contractor (Contractor/Company Name/Division and CAGE Code):

b. Address:

c. Contract Number:

d. Contract Type (Firm Fixed Price; Cost Reimbursement; T&M):

e. Prime Contractor Name (if different from the contractor name cited above):

f. Contract Award Date:

g. Forecasted or Actual Contract Completion Date:

h. Work Performed (Provide additional information):

i. Was this contract competitively awarded? Yes _____ No_____

j. Was this a follow-on contract? Yes _____ No _____

k. Period of Performance:

l. Place of Performance:

m. Security (please mark the security requirements which were included in your contract’s DD Form 254):

Top Secret Facility Clearance

Top Secret Safeguarding

Provision of a Sensitive Compartmented Information Facility

l. Your Title (e.g. PCO, ACO, COR, etc.) and period of involvement with the contract:

Title Period of Involvement

4. ADJECTIVAL RATINGS

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

PART II: (To be completed by the Point of Contact – Respondent)

5. QUESTIONS:

Technical Performance

1. To what extent did the service provider satisfy technical performance requirements, on an overall basis? Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

Comments:

2. To what extent did the service provider satisfy performance requirements? Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

3. To what extent did the service provider satisfy the types of work identified in individual Performance Work Statements? Please indicate the level of performance for each type of work.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

4. To what extent did the service provide offer effective project management (to include use and control of subcontractors)? Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

5. To what extent was the service provider committed customer satisfaction and concern for its customers’ interest? Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

Schedule Performance

1. To what extent did the Service provider meet required performance schedules, on an overall basis? Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

Cost Performance

1. To what extent did the contractor stay within cost estimates?

Please check one answer.

Outstanding

Good

Acceptable

Marginal

Unacceptable

Too soon to tell

Not applicable

7. RESPONDENT IDENTIFICATION

Please provide the following information:

a. Organization:

b. Name:

c. Title:

d. Date:

e. Telephone Number:

f. Address:

g. E-mail Address: