Attachment_1-Past_Performance_Questionnaire_(001052).doc

HSCG44-16-R-001052 Attachment 1 – Past Performance Questionnaire

U.S. COAST GUARD

C4IT Service Center-CPD-C3CEN

4000 Coast Guard Blvd., Annex 4

Portsmouth, VA 23703-2199

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

I. INSTRUCTIONS

The company (i.e., contractor) that sent you this questionnaire intends to submit an offer in response to a U.S. Coast Guard solicitation and has identified you as a reference to validate their performance. This PPQ must be completed by the person most familiar with the contractors’ performance on a present or previous contract and then submitted directly to the U.S. Coast Guard by the person completing the PPQ. Please DO NOT send the completed PPQ to the contractor being evaluated. In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. We are thanking you in advance for your time, effort, and cooperation in responding to this questionnaire.

Please submit the completed form via e-mail to D05-SMB-C4ITSC-CPD-C3CEN-TeamC@uscg.mil.

Please e-mail D05-SMB-C4ITSC-CPD-C3CEN-TeamC@uscg.mil if you have any questions.

The completed PPQ is due on or before the date/time listed on the SF-1449, Block 8. Unless the due date is extended via a Solicitation Amendment.

II. GENERAL INFORMATION

A.

PAST PERFORMANCE EVALUATOR & ORGANIZATION/COMPANY INFORMATION

Company Name:

B.

CONTRACTOR NAME & CONTRACT IDENTIFICATION

(if sub, also provide name of prime)

FORMCHECKBOX

Prime Contractor

FORMCHECKBOX

Subcontractor (Prime is_______________________________)

(e.g., difficult, routine):

III. GENERAL GUIDANCE

Please use the following ratings to score the performance elements below (assessments should reflect only contractor-liable performance):

IV. EVALUATION: Rate the contractor in each of the following Evaluation Areas.

A. Quality of Product or Service. Assess the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., specified technical, professional, environmental, or safety and health standards). List and assess any sub-elements to indicate different efforts where appropriate. For example: Are reports/data accurate? Does the service provided meet the specifications of the contract? Does the contractor’s work measure up to commonly accepted technical or professional standards? What degree of Government technical direction was required to solve problems that arise during performance?

Check (

Comment(s):

B. Schedule. Assess 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 effect the schedule variance). For example: Is the Contractor completing the services in a timely manner? Did the Contractor adequately schedule the work? Has the Contractor met administrative milestone dates? Has the Contractor meet physical milestone dates specified by contract, or agreed to, in the project schedule? If the schedule has slipped through the Contractor’s fault or negligence, has the Contractor taken appropriate corrective action of its own volition? Has the Contractor furnish all required deliverables on or ahead of schedule? Has the Contractor furnished updated project schedules on a timely basis?

Check (

Comment(s):

C. Cost Control. Assess the contractor’s effectiveness in forecasting, managing, and controlling contract or order cost. For example: Does the contractor keep within the total estimated cost (what is the relationship of the negotiated costs and budgeted costs to actuals)? Did the contractor do anything innovative that resulted in cost savings? Were billings current, accurate and complete? Are the contractor’s budgetary internal controls adequate? Has the Contractor notified the Government and taken necessary corrective actions when the cost estimate exceeds available funds? (Not required for Fixed Price type contracts or orders.)

Check (

Comment(s):

D. Management. Assess 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 and resolution of issues in controversy), customer satisfaction, timely award and management of subcontracts. Is the contractor oriented toward the customer? Is interaction between the contractor and your organization satisfactory, or does it need improvement? Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel. For example, how well did the contractor match the qualifications of the key position, as described in the contract, with the person who filled the key position? Did the contractor support key personnel so they were able to work effectively? If a key person did not perform well, what action was taken by the contractor to correct this? If a replacement of a key person was necessary, did the replacement meet or exceed the qualifications of the position as described in the contract schedule?

Check (

Comment(s):

E. Regulatory. Assess compliance with all terms and conditions in the contract or order relating to applicable regulations and codes. Consider aspects of performance such as compliance with financial, environmental (example: Clean Air Act, Clean Water Act), safety, and labor regulations, as well as any other reporting requirements in the contract.

Check (

Comment(s):

V. SUMMARY

Would your organization/company award another contract to this Contractor (or use the services of the Contractor again)? FORMCHECKBOX Yes / FORMCHECKBOX No In summary, if you care to, please give your overall assessment of this Contractor.

Do you have any additional comments to add?

“Source Selection Information—See FAR 2.101 and 3.104.”