Amendment_5_-_Attachment_C_-_Past_Performance_Questionnaire.pdf

Request for Proposal (RFP) # HSCG23-16-R-PFP021

Attachment C – Past Performance Questionnaire

Past Performance Questionnaire (Complete one form per reference)

Please fill out the following information in regards to the solicitation.

SECTION A – TO BE COMPLETED BY OFFEROR

Offeror’s Name:

Offeror’s DUNS Number:

Contract Number:

BPA Number:

Order Number:

_____ Prime or _____ Subcontractor (Check one)

Dollar Amount:

Period of Performance:

Contract Type:

_____ Fixed Price _____ Cost Reimbursement _____ Other (Specify)

(Check one)

Item/Service Description:

Contract Quantity/Period of Performance:

Customer/Business/Agency Name:

Customer POC (Note: Ensure POC information is valid and current) Name:

Address:

Phone:

E-mail:

SECTION B – TO BE COMPLETED BY THE POINT-OF-CONTACT

The offeror in Section A provided you as reference for a solicitation they are a party to. Please complete the rest of the evaluation.

Please email the completed evaluation no later than the date of IDIQ-level proposal submission to the joint attention of the Contract Specialist, Chief Warrant Officer (CWO) Joe

Tallent, at joe.b.tallent@uscg.mil and the Contracting Officer, Mr. Nathan Dolezal, at nate.dolezal@uscg.mil.

Evaluation

Indicate the contractor’s past performance for each category area and overall by identifying with an “X” mark for the most appropriate rating according to the scale shown below. Please provide a rationale, including specific examples, as appropriate, to support your ratings in the space provided for comments for each category area. If more space is needed, continue your comments in the “Additional Comments” section at the end of Table 3.

Table 1 provides the rating criteria for each category area.

TABLE 1- CATEGORY AREA

Rating Description

Quality of Service Assessment based on the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

Schedule Assessment based on the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements

(e.g., efforts that contribute to or affect the schedule variance).

Cost Control Assessment based on the contractor’s effectiveness in forecasting, managing, and controlling contract cost.

***If contract is/was Firm-Fixed Price (FFP) or Firm-Fixed Price with Economic

Price Adjustment (FFP EPA), please mark “Not Rated”***

Management of Key

Personnel

Assessment based on the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

Regulatory

Compliance

Assessment based on whether the contractor complied with statutes and regulations pertained in the Federal Acquistion Regulations mailto:joe.b.tallent@uscg.mil mailto:nate.dolezal@uscg.mil

Where appropriate, please use the ratings definitions in Table 2 below to assess the contractor’s performance. These are the same ratings that are used in the Past Performance Information

Retrieval System (PPIRS).

TABLE 2 - PERFORMANCE RATINGS DEFINITIONS

Rating Description

Exceptional The contractor’s performance met contractual requirements and exceeded many to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good The contractor’s performance met contractual requirements and exceeded some to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory The contractor’s performance met contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal The contractor’s performance did not meet some contractual requirements. The contractual performance reflected a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions were only marginally effective or were not fully implemented.

Unsatisfactory The contractor’s performance did not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains a serious problem(s) for which the contractor’s corrective actions were ineffective.

Not Rated Not applicable or has no history. A “Not Rated” is the equivalent of a “Neutral” rating.

Use the ratings in Table 3 to assess contractor performance where appropriate.

TABLE 3 - PERFORMANCE RATINGS

Category / Comments Rating

1. Quality of Service:

__Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__Not Rated

2. Schedule: __Exceptional

__Satisfactory

__Marginal

__Unsatisfactory

3. Cost Control:

__Satisfactory

__Marginal

__Not Rated*

(Choose “Not Rated” if prime contract was FFP or

FFP EPA)

4. Management of Key Personnel: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

5. Regulatory Compliance:

__Satisfactory

__Marginal

__Unsatisfactory

Additional Comments:

Based on the categorical ratings, use the Table 4 to assess contractor’s overall performance.

TABLE 4 – OVERALL PERFORMANCE RATING

Overall Comments Rating

__Exceptional

__Very Good

__Satisfactory

__Marginal