Attachment 3 Calibration Past Performance Questionnaire.doc

Client Authorization Letter (Addressee)

Dear “Client”, We are currently responding to the Government’s Request For Proposal HSCG38-08-R-500046 for the calibration and repair of various Test, Measurement and Diagnostic Equipment (TMDE) for the U.S. Coast Guard Aviation Logistics Center (USCG ALC), Elizabeth City, NC. The Government is placing increased emphasis in their acquisitions on the use of Past Performance as a source selection factor.

The Government has asked the offeror to send Past Performance Questionnaires to customers to be completed and returned to the Contracting Officer. Please complete the attached Past Performance Questionaire and submit to the USCG ALC Contract Specialist, Denise Hall via e-mail at Denise.P.Hall@uscg.mil or facsimile (252) 335-6452 by __________________________.

If you are contacted by the Government, you are hereby authorized to respond to their inquiries for information on work we have performed for your company.

Your cooperation is appreciated. Any questions relating to this matter may be directed to _____________________________________________________________________.

Sincerely, CONTRACTOR PERFORMANCE EVALUATION SURVEY

COVER SHEET

For Request For Proposal HSCG38-08-R-500046

Name and address of offeror questionnaire is being completed for:

Name of Company completing Questionnaire:____________________________________________________________

Contract Number:_________________________________________________________

Contract Type:___________________________________________________________

Contract Value:___________________________________________________________

Contract Period of Performance

Including Option Periods:___________________________________________________

Description of Services:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CONTRACTOR PERFORMANCE EVALUATION SURVEY RATING SHEET

Rating Scale:

Please use the following ratings to answer the questions contained in this survey. 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 “N/A”.

Note: For Statements indicating “Excellent” or “Poor”, please provide an explanation in the comments section of the survey.

Evaluation Survey Criteria

Rating

Description

superior

Average or the contractual performance was

Mostly favorable and corrective actions taken

By the contractor were effective

Which there were performance problems which

Were not satisfactorily corrected

Unsatisfactory and/or there were serious

Performance issues for which the contractor’s

Corrective actions were ineffective

CONTRACTOR PERFORMANCE EVALUATION SURVEY RATING SHEET

A. Quality of product or service:

Good/ Excellent Sat Marginal Poor N/A

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

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(2) The contractor submitted accurate

Reports FORMCHECKBOX

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(3) The contractor submitted timely

Reports FORMCHECKBOX

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(4) The contractor utilized personnel that were appropriate to the effort performed. FORMCHECKBOX

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B. Schedule:

(1) The tasks required under this effort were performed in a timely manner and in accordance with delivery schedules/time frames established in the contract. FORMCHECKBOX

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

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CONTRACTOR PERFORMANCE EVALUATION SURVEY RATING SHEET

C. Business Relationships: Excellent Sat Marginal Poor N/A

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

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(2) The contractor maintained an open line of communication so that the Contracting Officer’s

Technical Representative (COTR) and/or Technical

Point of Contact (TPOC) were apprised of technical, cost, and schedule issues. FORMCHECKBOX

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

(4) The contractor promptly notified the COTR, TPOC in a timely manner regarding urgent issues. FORMCHECKBOX

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D. Customer Satisfaction:

(1) The products/services provided adequately met the needs of the program. FORMCHECKBOX

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(2) The contractor was able to perform with minimal or no direction from the COTR or

TPOC FORMCHECKBOX

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CONTRACTOR PERFORMANCE EVALUATION SURVEY RATING SHEET

Excellent Sat Marginal Poor N/A

(3) I am satisfied with the performance of the contractor under this effort. FORMCHECKBOX

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E. Other:

(1) Would you award this firm another contract? FORMCHECKBOX Yes FORMCHECKBOX No If you answered “No”, please provide an explanation.

(2) Was the contract terminated for default? FORMCHECKBOX Yes FORMCHECKBOX No

If you answered “Yes”, please provide an explanation.

COMMENTS: (Required for ALL Excellent and Poor ratings)

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Attachment 3