Past Performance Questionnaire.doc
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- Attached to
- CGC ALERT DRYDOCK REPAIRS Federal contract opportunity
- Solicitation number
- HSCG80-12-R-P45B78
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Questionnaire
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PAST PERFORMANCE QUESTIONNAIRE
SOLICITATION NUMBER: HSCG80-12-R-P45547
USCGC VENTUROUS (WMEC-625) DRYDOCK REPAIRS
The Contractor shall submit this questionnaire to two references for completion and return to the U. S. Coast Guard, SFLC, Norfolk, Virginia, at the 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. If the contractor has Contractor Performance Reports in the CPARS Contractor Performance System, those may be used instead of this questionnaire. If no questionnaires are submitted for a contractor and there are no NIH Contractor Performance Reports to review, the contractor will receive a neutral rating.
EVALUATION INSTRUCTIONS
You have been requested to provide contract-related information for USCGC VENTUROUS (WMEC-625) DRYDOCK REPAIRS. 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, Poor, Fair, Good, Excellent, or Outstanding using the following rating guidelines. Space is provided for comments.
Please send the completed form directly to the mailing address, e-mail address or fax number listed below.
Commander
Surface Forces Logistics Center (SFLC) Attn: Mrs. Tara Holloway 300 East Main Street, Suite 550, 5th Floor Norfolk, VA 23510-9102
Email: Tara.M.Holloway@uscg.mil
Telephone: (757) 628-4754
RATING GUIDELINES
Quality of Product or Service 0 = Unsatisfactory 1 = Poor 2 = Fair 3 = Good 4 = Excellent 5 = Outstanding
| 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. |
| Poor |
| Overall compliance requires significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Overall compliance requires minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or very minimal, quality problems, and the Contractor has met the contract requirements. |
| Excellent |
| There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example for others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent". |
Cost Control 0 = Unsatisfactory 1 = Poor 2 = Fair 3 = Good 4 = Excellent 5 = Outstanding
| 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. |
| Poor |
| Ability to manage cost issues requires significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Ability to control cost issues requires minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or very minimal, cost management issues and the Contractor has met the contract requirements. |
| Excellent |
| There are no cost management issues and the Contractor has exceeded the contract requirements, achieving cost savings to the Government. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where the contractor achieved cost savings and performance clearly exceeds the performance levels described as "Excellent". |
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. |
| Poor |
| Delays require significant Agency resources to ensure achievement of contract requirements. |
| Fair |
| Delays require minor Agency resources to ensure achievement of contract requirements. |
| Good |
| There are no, or minimal, delays that impact achievement of contract requirements. |
| Excellent |
| There are no delays and the contractor has exceeded the agreed upon time schedule. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent". |
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. |
| Poor |
| Response to inquiries and/or technical, service, administrative issues is marginally effective. |
| Fair |
| Response to inquiries and/or technical, service, administrative issues is somewhat effective. |
| Good |
| Response to inquiries and/or technical, service, administrative issues is consistently effective. |
| Excellent |
| Response to inquiries and/or technical, service, administrative issues exceeds Government expectation. |
| Outstanding |
| The contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is |
expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent".
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
Ratings used in the NIH Contractor Performance System will be used to evaluate Past Performance. See the Rating Guidelines above.
| 0 |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| N/A |
| 1. |
| Quality of Product or Service – please rate |
Comments for Quality of Product or Service
| 2. |
| Cost Control – please rate |
Comments for Cost Control – please rate
| 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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