Past_Performance_Questionnaire.doc

Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Your assistance is requested in support of a best value competition. Please complete this questionnaire and email to Trellis.T.Martin@uscg.mil. If the questionnaire cannot be emailed, please mail this questionnaire to:

Mailing Address:

COMMANDANT (CG-9121)

ATTN Trellis Martin, Contracting Officer

US COAST GUARD

2703 Martin Luther King Jr. Ave SE Stop 7828

WASHINGTON DC 20593-7828

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION in accordance with Federal Acquisition Regulation (FAR) 2.101 and 3.104 and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

SECTION 1:

CONTRACT IDENTIFICATION

A. Contractor Name and Address:

B. Contract Number:

C. Was the Contractor the Prime Contractor or Subcontractor on this Contract? (Check Box):

FORMCHECKBOX

Prime Contractor

FORMCHECKBOX

Subcontractor

D. Contract Period of Performance:

E. Present Contract Value:

F. Total Contract Value:

“Total Contract Value” includes the full value of the contract, inclusive of options and all future contract work.

G. Type of Contract:

“Type of Contract” refers to whether the contract was or is Firm-Fixed Price (FFP), Time-and-Materials (T&M), Cost Plus Fixed Fee (CPFF), etc.

H. Description of Contract Requirements:

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

Please enter the requested information in Sections 2 and 3. After completion of these sections, transmit the completed questionnaire directly to the U.S. Coast Guard points of contact identified on page 1. Thank you for your assistance in this matter.

PLEASE DO NOT PROVIDE ANY COMPLETED QUESTIONNAIRES TO THE OFFEROR.

NOTE: If you have evaluated this contractor on this particular contract in CPARS or another evaluation system accessible to the Government, you may indicate in the space below that past performance information on this contract is available in an online evaluation system. Please provide the name of the appropriate system. You may include a copy of that rating in lieu of the following questionnaire.

SECTION 2:

EVALUATOR IDENTIFICATION

A. Evaluator’s Name:

B. Evaluator’s Position:

Evaluator’s Position refers to the job category (Contracting Officer, Program Manager, etc.)

that the evaluator performed or is performing during the evaluator’s involvement with the contract.

C. Evaluator’s Organization:

D. Evaluator’s Current Phone Number:

E. Evaluator’s Current Email Address:

F. Start Date and End Date of Evaluator’s Work with the Contract:

“Start Date and End Date” can be reported in a month and year format (e.g., June 2010 to June 2012).

SECTION 3:

EVALUATION

Please indicate your response for each topic that best reflects your experience with this contractor by placing an “X” in the appropriate block and provide narrative comments in the “Remarks” area. Use additional sheets as necessary. Please use the following rating scale to answer each rating question:

Exceptional

(EX)

Performance meets contractual requirements and exceeds many to the Government’s benefit.

Very Good

(VG)

Performance meets contractual requirements and exceeds some to the Government’s benefit.

Satisfactory

(SAT)

Past Performance met requirements.

Marginal

(MAR)

One or more examples where Past Performance failed to meet requirements due to the fault of the Contractor.

Unsatisfactory

(UNSAT)

One or more examples where Past Performance significantly failed to meet requirements due to the fault of the Contractor.

Please discuss every instance for which you indicated U (Unsatisfactory) in response to the questions below (use additional sheets, if neceAAry).

OVERALL CUSTOMER SATISFACTION

How would you rate your satisfaction with the contractor’s demonstrated business-like concern for the interest of its customer?

How would you rate your satisfaction with the contractor’s management of its internal or external design agent(s) to meet the requirements of the customer?

How likely would you be to select this firm again for contract award?

(E = very likely; VG = somewhat likely; S = neither likely nor unlikely; M = somewhat unlikely; U = very unlikely)

Remarks:

COST CONTROL

The contractor’s ability to manage the contract within budget.

The contractor’s ability to control costs.

The contractor’s ability to manage an acceptable ratio of negotiated costs to actual costs.

The contractor’s ability to bill timely in accordance with contract terms.

QUALITY OF PRODUCT

The contractor’s ability to demonstrate compliance with contract requirements.

The contractor’s ability to submit deliverables and accurately complete reports to the highest quality standards.

The contractor’s ability to demonstrate appropriate levels of expertise and professionalism.

The contractor’s ability to administer the contract in an acceptable and appropriate manner.

TIMELINESS OF PERFORMANCE

The contractor’s ability to meet all milestones as defined by the contract and customer.

The contractor’s ability to complete deliverables in a timely manner.

The contractor’s responsiveness to contract requirements and customer direction.

The contractor’s overall reliability.