Attachment 6 - Past Performance Questionnaire.doc
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- Calibration test and Repair Services of TMDE
- Solicitation number
- HSCG38-12-R-500001
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Attachment 6- Past Performance Form
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Attachment 6
PAST PERFORMANCE QUESTIONNAIRE
HSCG38-12-R-500001
Calibration Test and Repair Services SOLICITATION The Contractor shall submit this questionnaire to two references for completion and have the reference return to the U. S. Coast Guard, Aviation Logistics Center (ALC), Elizabeth City, NC, at the email address listed below. The offeror is responsible for ensuring that the questionnaire is completed and returned no later than the closing date of this solicitation (submitted by the reference). The Coast Guard will use any additional information as needed to determine contractor past performance.
EVALUATION INSTRUCTIONS
You have been requested to provide contract-related information regarding the corporate/commercial capabilities, experience and expertise with conducting Calibration Test and Repair Services. Please provide your assessment of the company’s level of past performance on the contract for which you are a reference. Mark the appropriate block, indicating whether the contractor’s / subcontractor’s past performance was Unsatisfactory, Marginal, Satisfactory or Superior using the following rating guidelines. Space is provided for comments.
Please send the completed form directly to the e-mail address or fax number listed below.
USCG, ALC
Attn: Patrick Morris william.p.morris@uscg.mil
Phone: (252) 334-5038 Fax: (252) 335-6272
RATING GUIDELINES
Quality of Product or Service 0 = Unsatisfactory 1 = Marginal 2 = Satisfactory 3 = Superior
| Unsatisfactory |
| Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements. |
| Marginal |
| Overall compliance requires minor Agency resources to ensure achievement of contract requirements. |
| Satisfactory |
| There are no, or very minimal, quality problems, and the Contractor has met the contract requirements. |
| Superior |
| There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government. |
Cost Control 0 = Unsatisfactory 1 = Marginal 2 = Satisfactory 3 = Superior
| Unsatisfactory |
| Ability to manage cost issues is jeopardizing performance of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, this level of ability to manage cost issues constitutes a significant impediment in consideration for future awards. |
| Marginal |
| Ability to control cost issues requires minor Agency resources to ensure achievement of contract requirements. |
| Satisfactory |
| There are no, or very minimal, cost management issues and the Contractor has met the contract requirements. |
| Superior |
| There are no cost management issues and the Contractor has exceeded the contract requirements, achieving cost savings to the Government. |
Timeliness of Performance
| Unsatisfactory |
| Delays are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards. |
| Marginal |
| Delays require minor Agency resources to ensure achievement of contract requirements. |
| Satisfactory |
| There are no, or minimal, delays that impact achievement of contract requirements. |
| Superior |
| There are no delays and the contractor has exceeded the agreed upon time schedule. |
Business Relations
| Unsatisfactory |
| Response to inquiries and/or technical, service, administrative issues is not effective. If not substantially mitigated or corrected it should constitute a significant impediment in considerations for future awards. |
| Marginal |
| Response to inquiries and/or technical, service, administrative issues is somewhat effective. |
| Satisfactory |
| Response to inquiries and/or technical, service, administrative issues is consistently effective. |
| Superior |
| Response to inquiries and/or technical, service, administrative issues exceeds Government expectation. |
Please ensure all of the following information is provided.
SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND 3.104
PAST PERFORMANCE QUESTIONNAIRE
Past Performance information is being requested on:
Name of Company being evaluated:
Address:
Contract Number:
Contract Type:
Period of Performance: From: To:
Total Contract Value: $
Description of Contract:
During the contract performance being evaluated, this firm was the ( Prime Contractor
( Subcontractor
| 0 |
| 1 |
| 2 |
| 3 |
| N/A |
| 1. |
| Quality of Product or Service – please rate |
Comments for Quality of Product or Service
| 2. |
| Cost Control – N/A |
X
Comments for Cost Control – N/A
This is not a cost type contract and therefore is not applicable.
| 3. |
| Timeliness of Performance – please rate |
Comments for Timeliness of Performance
| 4. |
| Business Relations – please rate |
Comments for Business Relations
Subcontracts
Were Subcontracts involved? ____Yes ____No
Comments for Subcontracts
Customer Satisfaction
Was the contractor committed to customer satisfaction? ____Yes ____No
Comments for Customer Satisfaction
Past Performance Information Provided by:
Name/Title:
Agency/Company:
Address:
Phone: Fax:
SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND 3.104
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