Attachment_(3)_Past_Performance.pdf

REQUEST FOR PROPOSAL: HSCG84-15-R-AA9471

FULL FOOD SERVICE AT USCG SECTOR SAUALT STE MARIE, MI

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

SECTION A: Contractor Information (to be completed by the contractor prior to mailing or faxing to respondent)

1. Contractor’s Title, Name and Address: __________________________

2. Point of Contact: __________________________

3. Phone Number (with area code): __________________________

4. Contract Number: __________________________

5. Contract Effort Description:

SECTION B: Respondent Information:

(To be completed by Respondent, i.e., Commercial Sector or Government)

1. Respondent’s Title, Name and Address: __________________________

2. Phone Number & email address: __________________________

3. Contract Specifics:

a. Contract Number: __________________________

b. Contract Type (CIRCLE ONE):

Firm-Fixed-Price Indefinite Quantity/Task Order Cost-Reimbursement

c. Start Date / End Date: __________________________

d. Original Contract Amount: __________________________

Attachment (3)

e. Current Contract Value: __________________________

f. Estimated Value at Completion: __________________________

Please e-mail the completed questionnaire by 5/11/2015 to: brenda.s.bartlett@uscg.mil

**SEE ATTACHED PAGES FOR MORE INFORMATION ON FACTORS BEING RATED**

PAST PERFORMANCE EVALUATION OFFEROR’S REFERENCE QUESTIONNAIRE

1. Complete this questionnaire using the grading system explained below. Your assessment should only consider performance for which the contractor is responsible and accountable.

Each offeror shall be assigned one the following ratings:

(E) Exceptional- Performance meets contractual requirements and exceeds many to the company’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

(VG) Very Good- Performance meets contractual requirements and exceeds some to the company’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

(S) Satisfactory- Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

(M) Marginal- Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

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

(N) NOT APPLICABLE/UNKNOWN CONFIDENCE - Unable to provide a score. Performance in this area is not applicable to effort assessed.

2. Please circle the rating, the appropriate letter, for each item on the questionnaire, which most accurately describes the contractor’s performance. Provide frank, concise comments or supporting narrative explanations in the spaces provided. When responding to the descriptive statements, select the answer, which most accurately describes the contractor’s performance or situation. You may use additional sheets if more space is needed.

mailto:brenda.s.bartlett@uscg.mil

A. Quality:

VG S M U N

B. Schedule:

VG S M U N

C. Cost Control:

VG S M U N

D. Management:

VG S M U N

E. Regulatory Compliance.

VG S M U N

F. Other Areas.

VG S M U N