A4PPQ.DOC

U.S. Coast Guard (USCG)

PAST PERFORMANCE QUESTIONNAIRE

HSCG23-15-R-PCI035

PAST PERFORMANCE QUESTIONNAIRE

HSCG23-15-R-PCI035

Offeror Being Evaluated

Company Completing Questionnaire

Contract Number

Delivery Order/Task Order Number

Evaluator Point of Contact

Length of Involvement with Offeror

Deliverable / Service Description

EVALUATION INSTRUCTIONS

The USCG Acquisition Directorate proposes to acquire contractor support services for Long Range Identification and Tracking (LRIT) system. Services shall include: (1) conformance tests, (2) integration of vessels into the LRIT system, (3) position reports, (4) customer support, (5) system status messages, and (6) a testing environment for the U.S. National Data Center.

This questionnaire will be used by the USCG to obtain and evaluate past performance information from references listed in the Offeror’s proposal.

Please provide your assessment of the company’s level of past performance on the contract for which you are a reference. Mark the appropriate block based on the rating guidelines. Space is provided for comments.

Thank you in advance for your response.

Submit completed Cover Sheet and Questionnaire to Jackson.McClam@uscg.mil.

RATING SCALE

Please use the following ratings to provide a rating for each area. If you are unable to rate an item because it was not a requirement or you have no knowledge of the item in question, then you should mark “NA”.

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 were 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 were 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.

1. Quality of Product or Service

2. Schedule

3. Cost Control

4. Business Relations

5. Management of Key Personnel

Any additional comments to supporting ratings:

SOURCE SELECTION SENSITIVE – SEE FAR 2.101 AND 3.104