Attachment_8 _Past_Performance_Questionnaire_05-04-15_AES.doc

ATTACHMENT 08: PAST PERFORMANCE QUESTIONAIRE

FOR SOLICITATION HSCG23-15-R-PQG001

CONTRACT INFORMATION:

A. Contractor: _________________________

B. Contractor Address: ___________________

C. Contract Number: _______________________ Status: Active _____ Completed _____

D. Contract Amount: $______________

E. Period of Performance: ______________________

F. Products / Services Provided (Explain in detail the type of products / services provided by the contractor):

RESPONDENT IDENTIFICATION (***NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS***)

A. Name: ________________________________________________

B. Position and Title: _______________________________________

C. Phone Number: _________________________________________

D. Address: _______________________________________________

E. Length of time your firm has been involved with the offeror: _____________________

F. Date questionnaire was completed: ________________________________

SUBMIT PAST PERFORMANCE QUESTIONNAIRE BY APRIL 16, 2015 TO:

Tim Gerhart

Contract Specialist

Email: tim.gerhart@uscg.mil

RATING SCALE

1. In this section of the questionnaire you are asked to rate the offeror. This procurement is being conducted on a Low Priced Technically Acceptable basis. If you are unable to rate an item because it was not a requirement, never an issue, or you have no knowledge of the item in question, then you should mark “NA”. If you wish to elaborate on any of your answers, please provide comments at the end of this section.

2. ONCE COMPLETED, THIS SURVEY WILL BE CONSIDERED SOURCE SELECTION SENSITIVE IN ACCORDANCE WITH FAR PART 3.104.

3. The following definitions are applicable rating levels for the contractor’s performance:

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.

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

CONTRACTOR PERFORMANCE EVALUATION SURVEY

(1) The Contractor provided a product or service that conformed to contract requirements, specifications, and standards of good workmanship.

(2) The Contractor submitted accurate reports.

(3) The Contractor utilized personnel that were appropriate to the effort performed.

Supporting Narrative: ________________________________________________________________________________ b.) SCHEDULE:

(1) The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract

(2) The Contractor was responsive to technical and/or contractual direction.

Supporting Narrative: ________________________________________________________________________________ c.) MANAGEMENT:

(1) The Contractor demonstrated effective management over the effort performed.

(2) The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) was apprised of technical, cost, and schedule issues.

(3) The Contractor presented information and correspondence in a clear, concise, and businesslike manner.

(4) The Contractor promptly notified the COR and the Contracting Officer in a timely manner regarding urgent issues.

(5) The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical program issues.

(6) The Contractor made timely award to, and demonstrated effective management of, its subcontractors.

(7) The Contractor demonstrated an effective small/small disadvantaged business subcontracting program.

Supporting Narrative: _____________________________________________________________________________

ADDITIONAL COMMENTS: