Past_Performance.doc

HSCG40-09-Q-50106

Attachment B

RELEVANT PAST PERFORMANCE QUESTIONNAIRE

Note: To be completed by your references and returned by your references to the Contract Specialist by 01/07/2010. Failure to do so may result in rejection of your quotation.

Your organization has been identified for participation in the relevant past performance evaluation on a current solicitation at the United States Coast Guard (USCG), Baltimore, Maryland. This survey will be used to evaluate the relevant past performance for the contractor and contracting action identified below.

Your candid response to the questions is important to our evaluation effort and may affect the award outcome. Please indicate "N/A" in any area which is not applicable to work performed on your contracting action. In accordance with Office of Federal Procurement Policy (OFPP) Letter Number 92-5, the names of individuals supplying relevant past performance information will remain confidential.

Please take a moment to complete the enclosed survey and email or fax the completed and signed survey to the contact listed below by 01/07/2010. A representative of USCG may contact you to arrange a time for a phone interview to review the survey. If you have any questions regarding this survey please contact Paul Premoe [USCG Contract Specialist] at:

Email: Paul.B.Premoe@uscg.mil

Phone: 410.762.6078 Fax:

410.762.6095 The following information is being requested:

Contract number:

Contractor’s name, operating unit and address:

Type of contract:

Program Name:

Contract Initiation date:

Contract completion date (including extensions):

Years Remaining:

Describe any schedule changes and reasons for schedule changes (if any):

Award Amount:

Current Contract $ Value (including exercised options and extensions):

Projected Final Contract $ Value (including exercised options and extensions):

Reason why Award Amount and Current or Projected Final Contract $ Value differ (if they differ):

Description of the work performed (include the size, scope, and complexity of the project):

Evaluators name, position, organization, and role on the contract:

Evaluator’s phone # and email address:

Number of month’s contractor performance was monitored by evaluator:

1. Please rate each item listed below (circling is preferable; Use 1 through 5 with 5 being outstanding and 1 being unsatisfactory; N/O (Not Observed)) and Provide Comments to identify Specific Strengths/Weaknesses in each area

1 – Substantially did not meet expectations for this element

2 – Met most (>80%) expectations for this element

3 – Met all expectations for this element

4 – Met all expectations and exceeded some expectations for this element

5 – Substantially exceeded expectations for this element

A1. Quality of Products or Services: Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

A2. Proficiency in:

A3. Management of Key Personnel: Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

Comments (List specific strengths and weaknesses):

B. Timeliness of Performance - Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Comments (List specific strengths and weaknesses):

C. Cost Control - Assess the contractor’s effectiveness in forecasting, managing, and controlling contract costs (*Do not rate this item for Firm Fixed Priced contracts).

Comments (List specific strengths and weaknesses):

D. Business Relations - Assess the integration and coordination of relationships needed to execute the contract

Comments (List specific strengths and weaknesses):

E. Resolution of Problems - Assess the contractor’s performance in resolving problems that arose during performance of the contract.

Comments (List specific strengths and weaknesses):

2. Overall Assessment: (please circle)

NOT OBSERVED

Comments (List any major strengths and major weaknesses):