Encl_5_(PPQ).docx

Solicitation: HSCG23-14-R-MMC007 Enclosure 5

PAST PERFORMANCE QUESTIONNAIRE

Contractor Being Evaluated:

Agency Name:

Contract Number:

Delivery Order/Task Order Number:

Contract Value ($):

Evaluator Point of Contact Information:

Period of Performance:

Scope of Project or Description of Deliverables/Service:

EVALUATION INSTRUCTIONS—PLEASE TYPE YOUR RESPONSES

This questionnaire will be used to obtain past performance information from a reference listed in the Contractor’s solicitation response. Please provide your assessment of the Contractor’s level of past performance on the contract for which you are a reference. Mark (X) the appropriate block using the following rating guidelines. Please provide comments for each of the headings.

Submit completed Questionnaire by the RFP due date via e-mail to: james.f.ferguson@uscg.mil.

Ratings

No Rating

(NR)

Used if you are unable to rate an item because it was not a requirement and does not apply, or you have no knowledge of the item in question. Please explain in the comments section. This is neither a negative or positive assessment.

Exceptional

(EX)

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective action taken by the contractor was highly effective. (To justify an exceptional rating, identify multiple significant events and state how they were of benefit to the Government.)

Very Good

(VG)

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective. (To justify a very good rating, identify a significant event and state how it was a benefit to the Government.)

Satisfactory

(SAT)

Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective actions taken by the contractor were satisfactory. (To justify a satisfactory rating, there should have been only minor problems, or major problems the Contractor recovered from without impact to the contract.)

Marginal

(MAR)

Performance does not meet some contractual requirements. The contractual performance of the element being assessed 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. (To justify a marginal rating, identify a significant event that the contractor had trouble overcoming and state how it impacted the Government.)

Unsatisfactory

(UNSAT)

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. (To justify an unsatisfactory rating, identify multiple significant events that the Contractor had trouble overcoming and state how it impacted the Government.)

A.) QUALITY OF PRODUCT OR SERVICE: Assess Contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

COMMENTS:

B.) SCHEDULE: Assess timeliness of Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect schedule variance).

COMMENTS:

C.) COST CONTROL: (Not required if contract type is Fixed-Price.) Assess Contractor’s effectiveness in forecasting, managing, and controlling contract cost.

COMMENTS:

D.) BUSINESS RELATIONS: Assess integration and coordination of all activity needed to execute the contract, specifically, the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, Contractor’s history of reasonable and cooperative behavior (to include timely identification of issues and controversy), customer satisfaction, and timely award and management of subcontracts.

COMMENTS:

E.) MANAGEMENT OF KEY PERSONNEL: Assess Contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

COMMENTS:

Thank you for your time.

SOURCE SELECTION SENSITIVE - SEE FAR 2.101 & 3.104