P45022 _Attachment_4 _Past_Performance_Evaluation_Survey.pdf

Attachment (4)

U.S. COAST GUARD

SURFACE FORCES LOGISTICS CENTER (SFLC) EAST

CONTRACTING & PROCUREMENT DEPARTMENT (MECPL)

CONTRACTOR EVALUATION FORM

The Coast Guard, Surface Forces Logistics Center (SFLC), (MECPL) is currently procuring Dining and Lodging for crewmembers of the USCGC ALERT. As a result, we are performing a survey and reference investigation on possible contractors for the upcoming contract.

The information contained herein is considered “Source Selection Information” in accordance with FAR 3.104. Therefore, it is asked that you treat it accordingly. While the results of the overall past performance survey may be discussed with the contractor, FAR Part 15.610 and

15.1004 prohibits the release of the name of the individual responding to the survey.

Responses to this questionnaire should be EMAILED TO MAGDALENA PITRE AT Magdalena.n.pitre@uscg.mil by October 12, 2016 at 2:30 PM ET.

Should you have any questions concerning this survey, please contact the above named person at (757) 628-4754.

I. CONTRACT IDENTIFICATION:

NAME OF CONTRACTOR BEING RATED:

CONTRACT NUMBER:

CONTRACT TYPE:

PERIOD OF PERFORMANCE:

PRICE OF CONTRACT:

TYPE OF SERVICE PROVIDED:

RESPONDENT’S NAME:

PHONE:

E-Mail

FAX:

RESPONDENT’S COMPANY NAME:

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION

SEE FAR 3.104

II. GENERAL GUIDANCE:

A common five level assessment rating system is used to evaluate a contractor’s performance. Ratings range from Unsatisfactory to Exceptional. Here is a breakdown of each category:

0 = Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

1 = Marginal Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

2 = Satisfactory Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

3 = Very Good Performance meets contractual requirements and exceeds some to the Governments benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

4 = Exceptional Performance meets contractual requirements and exceeds many to the Governments benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

IF AN ELEMENT IS NOT APPLICABLE TO YOUR SERVICES, PLEASE RATE AS N/A.

III. QUALITY OF PRODUCT or SERVICE:

1. Did the customer get what was specified

2. Did the customer consider the final product high in quality

3. If warranty issues arose, were they promptly corrected

4. Type of Reverse Osmosis Desalination Plant Installed?

5. Was the installation performed by the prime or subcontractor?

OVERALL RATING FOR QUALITY OF SERVICE:

COMMENTS:_______________________________________________________________

IV. SCHEDULE:

1. Was the contract completed on time? If not, reason why (growth work, contractor delayed, government delayed?

OVERALL RATING FOR SCHEDULE:

COMMENTS:______________________________________________________________

V. BUSINESS RELATIONS / MANAGEMENT & MANAGEMENT RESPONSIVENESS:

1. How was their customer service?

2. Was the Contractor committed to customer satisfaction?

3. Would you use this company again (Why / Why not)?

OVERALL RATING FOR BUSINESS RELATIONS / MANAGEMENT &

MANAGEMENT RESPONSIVENESS:

VI. MANAGEMENT OF KEY PERSONNEL / SUBCONTRACTORS:

1. Contractor’s preparation and training of personnel.

2. Contractor’s compliance with contractual terms and conditions.

3. Were subcontractors involved? Please use comments below.

OVERALL RATING FOR MANAGEMENT OF KEY PERSONNEL

/SUBCONTRACTORS:

VII. ADDITIONAL COMMENTS ON ANY RATING ELEMENT CAN BE MADE BELOW: