Attachment 5 - TEDSS-Past Performance Questionnaire.doc

Past Performance Questionnaire – Attachment 5

Proposed Form Letter:

One of the considerations in proposal evaluation is the verification of the offeror’s past and present performance on contracts, which reflect the offeror's ability to perform on the proposed effort. We depend on information received from agencies such as yours, which have had firsthand experience with an offeror, for the evaluation of the offeror's performance on those contracts.

Our areas of interest in the offeror are summarized in the enclosed questionnaire. Our schedule is extremely tight and we need your written response no later than the date proposals are due to this office. This schedule will allow us sufficient time to analyze the data prior to evaluation.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out by hand and faxed to (757) 686-4099 (ATTN: Linda Nash-Gallaher), or email to Linda.L.Nash-Gallaher@uscg.mil.

Please contact the above POC at (757)686-4099 prior to transmission or if you have any questions. Your completed questionnaire will become a part of the official Source Selection records.

Your prompt attention to this questionnaire will be greatly appreciated and will be one of the keys to the successful and timely completion of this Source Selection.

//signed - CD//

CHERISH DRIVER

Contracting Officer

Attachment:

Past Performance Questionnaire

PAST PERFORMANCE QUESTIONAIRE

The below-named contractor/offeror is being considered for award of a contract for TEDSS at the Command, Control and Engineering Center, Portsmouth, Virginia. A primary consideration in our selection process is the contractor’s history of performance of similar efforts. Please make every effort to be thorough in your answers/comments. Completed questionnaires can be returned via fax, email or mail to the following:

United States Coast Guard, C3CEN ATTN: Linda Nash-Gallaher 4000 Coast Guard Blvd.

Portsmouth, VA 23703

A. GENERAL INFORMATION

Offeror’s Name:_______________________________________________________________________________

Address:_____________________________________________________________________________

Telephone Number:________________________ Point of Contact:____________________________

B. RESPONDENT INFORMATION

Name:_____________________________________ Title:_____________________________________________

Organization & Address:_________________________________________________________________________

Telephone: ___________________ FAX:__________________ Email:___________________________________

C. CONTRACT INFORMATION

Contract Title:______________________________________________________________________

Period of Performance:__________________________ Contract Number:__________________________________

Total contract value, including all modifications and options:__________________________________

Annual contract expenditures:__________________________________________________

Total occupied square footage of facilities supported:_______________________________________

Number of separate and distinct commodities provided under contract:_________________________

Description of contract effort:___________________________________________________________

(Include whether the effort supported a multi craft facility maintenance operation providing building supplies, repair parts and system components to carpenters, electricians, heating, ventilation and air conditioning mechanics, plumbers, and entomologists)

D. PERFORMANCE INFORMATION

The U.S. Coast Guard will use your survey responses to determine a level of confidence, based on the offeror’s past performance record, concerning the offeror’s ability to successfully perform our requirement in accordance with the contract. Please assign the following performance level codes to each of the questioned areas listed below based on the contractor’s performance at your organization or installation. The confidence codes selected will indicate the degree of doubt concerning performance in each area.

RESPONDENT WILL NOT FURNISH ANY PAST PERFORMANCE INFORMATION TO OFFEROR SUBMITTING A PROPOSAL FOR THIS SOLICITATION.

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Please provide detailed narrative comments to support your ratings. At a minimum, please discuss each response for which you indicated E (Exceptional), M (Marginal) or US (Unsatisfactory) in response to the questions below (use additional sheets, if necessary).

E. PERFORMANCE EVALUATION AREAS

Please use the above ratings and their assigned definitions to describe the offeror’s performance in the following areas:

1. Contractor’s ability to provide user support to access the/a system via a web browser without requiring client software.

2. Contractor’s ability to maintain a fully functional web-based system with standard industry capabilities, inclusive of the provision of on-site IT support to various sites, and the provision of HW/SW technical response needs in a timely fashion.

3. Contractor’s ability to respond to urgent requirements with adequate personnel in timely fashion

4. Contractor’s ability to maintain an educated and qualified workforce.

5. Overall contract compliance in providing response to task order requirements at a fair and reasonable price

6. Contractor maintained acceptable level of performance for task orders

7. Contractor provided on-time delivery within original delivery date

8. Contractor’s overall quality of customer service

9. Contractor’s willingness and effectiveness in correcting identified deficiencies in service and/or supplied items

10. Overall quality of service

11. Contractor met all applicable environmental requirements

12. Contractor provided experienced managers and supervisors with technical and administrative abilities to meet contract requirements

13. Contractor effectively managed materials requirements: (i.e. maintained adequate stock levels)

14. Contractor maintained records/reported data

15. Contractor’s overall management and responsiveness

COMMENTS/REMARKS_______________________________________________________

F. If a government contract, did the contractor receive any Contract Discrepancy Reports, Letters of Concern, or Cure Notices?_____________ If yes, please describe:

G. If given the opportunity, would you award another contract to this contractor?_______

Please explain response below:

H. How would you rate the contractor’s overall performance? E VG G M US N/A

Signature of Respondent___________________________________ Date____________

Job Title:________________________________________________________________

Thank you for taking the time to complete this questionnaire.

LEGEND OF TERMS

OFFEROR: The contractor for which past performance is being evaluated

SOLICITATION NUMBER: The procurement document number the government uses to identify a specific Request for Proposal (RFP)

RESPONDENT: The person and/or organization evaluating past performance

CONTRACT NUMBER: If the offeror had a contract or purchase order with your company/firm, the identifying contract number associated with awarded contract/purchase order

CONTRACT TITLE: Project title of work performed

CONTRACT VALUE: Contract/purchase order total dollar value, including all modifications and options

BRIEF DESCRIPTION OF WORK: Describe type of work being performed, to include whether the effort supported a Technical Engineering Development and/or support services effort.

Thank you for your prompt response!