Section L Attachment 1- PP Quest.docx
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- Security Assistance Program Services (SAPS)
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- HSCG23-11-R-PMF001
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Section L Attachment 1 PP Questionnaire
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Text version
SOLICITATION NUMBER: HSCG23-11-R-PMF001
Section L, Attachment 1
PAST PERFORMANCE
QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and return to:
Mailing Address:
COMMANDANT (CG-9126)
ATTN Eric C. McDoniel, Contracting Officer
US COAST GUARD
2100 2ND ST SW STOP 7112
WASHINGTON DC 20593-7112
FAX: 202-475-3428
EMAIL: eric.c.mcdoniel@uscg.mil
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION IAW (41 U.S.C. 423) and shall be protected accordingly
TO BE COMPLETED BY OFFEROR
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor Name and Address:
B. Contract No:
C. Contract Initiation Date:
D. Completion Date: ____________________________________________
E. Contract Value:
F. Type of Contract:
G. Description of Contract Requirements:
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
Please enter the requested information in SECTIONS 2 and 3, then transmit the completed questionnaire to the U.S. Coast Guard point of contact identified above. Thank you for your assistance in this matter.
PLEASE DO NOT PROVIDE COMPLETED QUESTIONNAIRES TO THE OFFEROR
SECTION 2: EVALUATOR IDENTIFICATION
A. Evaluator’s name: ___________________________
B. Evaluator’s Position: ____________________________
C. Evaluator’s Organization: ____________________________
D. Evaluator’s phone number:____________________________
E. Months Performance Monitored By Evaluator: ____________
SECTION 3: EVALUATION
Please indicate your response for each topic that best reflects your experience with this contractor by placing an “X” in the appropriate block using the scale as defined below:
| RATING |
| DEFINITION |
| EXCEPTIONAL (E) |
| Exceeds specified minimum performance or capability requirements in a way beneficial to the organization |
| ACCEPTABLE (A) |
| Meets specified minimum performance or capability requirements necessary for acceptable contract performance. |
| MARGINAL (M) |
| Does not clearly meet some specified minimum performance or capability requirements necessary for acceptable contract performance, but any proposal inadequacies are correctable. |
| UNACCEPTABLE (U) |
| Fails to meet specified minimum performance or capability requirements. Proposals with an unacceptable rating are not awardable. |
| NONE AVAILABLE (NA) |
| No record of past performance or the record is inconclusive. |
NOTE: If you have rated this contractor on this particular contract or project in CPARS or some other evaluation system accessible to the Government, you may indicate that past performance information on this contract/project is available in the appropriate system and you may include a copy of that rating in lieu of the following questionnaire.
Please discuss every instance for which you indicated U (Unacceptable) in response to the questions below (use additional sheets, if necessary).
| QUALITY OF PRODUCTS AND SERVICES – Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health) |
| E |
| A |
| M |
| U |
| NA |
Remarks:
| PERFORMANCE – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project. |
| E |
| A |
| M |
| U |
| NA |
| SCHEDULE– Assess the timeliness of contractor against schedule of activities. |
| E |
| A |
| M |
| U |
| NA |
| TECHNICAL REQUIREMENTS – Assess the contractor’s ability to fulfill the technical requirements of the contract. |
| E |
| A |
| M |
| U |
| NA |
| COST CONTROL – Assess the contractor’s ability to manage the contract budget and control costs. |
| E |
| A |
| M |
| U |
| NA |
| CUSTOMER SATISFACTION– Assess the contractor’s responsiveness to customer concerns. |
| E |
| A |
| M |
| U |
| NA |
OVERALL ASSESSMENT
| E |
| A |
| M |
| U |
| NA |
If an Award Fee contract, what was the average Award Fee % earned?
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