Attachment_2_-_Past_Perf_Questionnaire.pdf

Solicitation#: HSCG23-17-R-PBR005

ATTACHMENT 2

PAST PERFORMANCE QUESTIONNAIRE

Instructions: Complete one (1) Past Performance Questionnaire per reference. The Offeror is to complete Section A and the Reference is to complete Section B. Upon completion of Section B, the Reference shall email the complete form to Shawna.L.Mitchell@uscg.mil by the closing date of the solicitation.

SECTION A – TO BE COMPLETED BY OFFEROR

Contract Number:

BPA Number:

Order Number:

_____ Prime or _____ Subcontractor (Check one)

Dollar Amount: Date Completed:

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 REFERENCE

The Offeror in Section A provided you as a reference for the solicitation identified above with the U.S.

Coast Guard. Please rate the Offeror in the areas identified below, utilizing the following ratings (circle appropriate response):

Evaluation

Provide a rating for the Contractor’s past performance in Tables 3 and 4, by identifying with an “x”, the most appropriate rating according to the scale shown in Table 2. When possible, provide rationale and/or specific examples to support your ratings in the space provided for comments for each category area. Use the criteria for each category area in Table 1 in the assessment.

Use the rating definitions in Table 2 to assess contractor performance where appropriate.

TABLE 2 - PERFORMANCE RATINGS DEFINITIONS

Rating Description

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

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 or Firm-Fixed Price with Economic Price Adjustment, please mark “Not Applicable”***

Business Relations Assessment based on the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.

Management of Key Personnel

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

Utilization of Small Business

Assessment based on whether the contractor provided maximum practicable opportunity for Small Business including Women Owned Small Businesses, Economically Disadvantaged Women Owned Small Businesses, HUBZone, Service Disabled Veteran Owned Small Business, and 8(a) to participate in contract performance consistent with efficient performance of the contract. Also assessment based on compliance with all terms and conditions in the contract relating to Small Business participation (including FAR 52.219-8, Utilization of Small Businesses and FAR 52.219-9, Small Business Subcontracting Plan (when required).

***If Contractor is a Small Business Concern then mark Not Applicable”***

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated 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 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.

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 relevant performance record is identifiable upon which to base a meaningful performance rating. A search was unable to identify any relevant past performance information for the Offeror, key personnel, or subcontractors. In the case of an Offeror without a record of relevant past performance or for whom information on past performance is not available, the Offeror may not be evaluated favorably or unfavorably on past performance.

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

TABLE 3 - PERFORMANCE RATINGS

Category Rating

1. Quality of Service:

__Exceptional __Very Good __Satisfactory __Marginal __Unsatisfactory __Neutral

2. Schedule: __Exceptional __Very Good __Satisfactory __Marginal __Unsatisfactory __Neutral

3. Cost Control:

__Satisfactory __Marginal __Unsatisfactory __ Neutral

4. Business Relations: __Exceptional __Very Good __Satisfactory __Marginal __Unsatisfactory __ Neutral

5. Management of Key Personnel: __Exceptional __Very Good __Satisfactory __Marginal __Unsatisfactory __ Neutral

6. Utilization of Small Business:

__Satisfactory __Marginal __Unsatisfactory

Additional Comments:

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

TABLE 4 – OVERALL PERFORMANCE RATING

Overall Rating __Exceptional

__Very Good __Satisfactory __Marginal __Unsatisfactory