PastPerformanceQuestionaire.pdf

Attachment 3: PAST PERFORMANCE QUESTIONNAIRE

HSCG23-15-R-MOT004

Please complete this Questionnaire and e-mail Contract Specialist, e-mail: michael.colisao@uscg.mil

We are currently in the process of preparing a proposal for The United States Coast Guard. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency under the previous/current contract listed below. Your input on our performance is therefore requested.

Please complete this Questionnaire and e-mail to CWO Michael Colisao, Contract Specialist, michael.colisao@uscg.mil

Questionnaire is due to CWO Michael Colisao, no later than 4:00 PM Eastern Standard Time on 27 August 2015.

If you will not be available before 27 August 2015 for verification of this past performance evaluation, please indicate another POC for the contacting officer to contact. Please provide this alternate reference no later than 4:00 PM Eastern Standard Time on 25 August 2015.

Alternate POC name: ________________________________________

Alternate POC phone number: _________________________________

Alternate POC e-mail address: _________________________________

Thank you.

NAME OF OFFEROR:

Phone: Fax:

E-Mail:

I. Current or Historical Contract Information

CONTRACT REFERENCED:

1. Contract Number: ________________________________________________

2. Contract Value: _____________________________________________________________

3. Period of Performance:

4. Brief description of items provided:

5. Name of Person Completing Questionnaire: _______________________________________

Agency/Company:

Title: __________________________________ Phone: _____________________________

E-mail: _____________________________________________________________________

II. EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

Evaluation Definitions –

The following definitions should be used in the assessment of Contractor performance.

EXCEPTIONAL

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

VERY GOOD

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

SATISFACTORY

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL

Performance does not meet some contractual requirements. The contractual performance of the element or sub-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.

UNSATISFACTORY

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.

NEUTRAL No performance record is available.

Past Performance Evaluation

Question 1. Performance

What is your assessment of the Contractor’s ability to meet your requirements?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Performance

Comments, if any.

Questions 2 and 3. Timeliness

What is your assessment of the Contractor’s ability to provide services in a timely manner?

Timeliness

Ability to Resolve Timeliness Problems

Question 4. Management of Personnel, including Key Personnel

What is your assessment of the Contractor’s ability to meet requirements of shipping (including packing, marking, etc) and the overall quality of the delivery?

Quality of Shipments

Question 5. Overall Rating of Contractor’s performance

What is your overall rating of Contractor’s performance (requirements, schedule, and price) on contract being assessed?

Exceptional Very Good Satisfactory Marginal Unsatisfactory

General Comments: