Attachment_5_-_Past_Performance_Questionnaire.pdf

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Attached to
Sealift Transporations Services - GTMO Federal contract opportunity
Solicitation number
HTC711-14-R-W001
Issued by
Department of Defense United States Transportation Command

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Att. 5 Past Performance Questionnaire

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GTMO_Q A_FBO_(10.08.14).pdf PDF
Attachment_1_(Revised)_-_GTMO_PWS.pdf PDF
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GTMO_Solicitation_-_Preproposal_Q A_(9.26.14).pdf PDF
GTMO_Pre-Proposal_Conference_Slides.pdf PDF
HTC711-14-R-W001-0001.pdf PDF
Attachment_2_-_GTMO_Rate_ _Pricing_Schedule_(Rev_1).xlsx XLSX spreadsheet
Attachment_8-_QASP.pdf PDF
Map_for_GTMO_Pre-Proposal_Conf.pptx PPTX presentation
Attachment_1-_GTMO_PWS_.pdf PDF
Attachment_4_-_Contractor_Confirmation_Checklist.pdf PDF
Attachment_6_-_Cyber_Security_Guidelines_and_Lessons_Learned.pdf PDF
RFP_HTC711-14-R-W001.pdf PDF
Attachment_7-_SCA_Wage_Determination_2005-2115.pdf PDF
Attachment_3_-_CARE_SA_Instructions.pdf PDF
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HTC711-14-R-W001

Attachment 5

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WORK PERFORMED IDENTIFICATION

Contractor (Company/Division):

Contract Number/Type (FFP, CPFF, etc):

Work Performed Title:

Brief Description of Work Performed (Please include quanties, monthly or annually, by breakbulk and containerized shipped under this contract; total number of voyages; and location of service performed):

Overall Dollar value:

Period of Performance:

Did you serve as the: _______ Prime or ______Subcontractor (If subcontractor, what percentage of overall service was provided ________)

SECTION 1: CONTRACT IDENTIFICATION

INSTRUCTIONS: This section is to be filled out by the contractor requesting information and sent to the respondent.

SECTION 2: RESPONDENT INFORMATION

INSTRUCTIONS: The remaining sections are to be filled out by Respondent. Once completed, respondent sends to USTRANSCOM Acquisition Office via E-mail to: melinda.j.lewis9.civ@mail.mil and david.m.hoag.civ@mail.mil . Please indicate “Performance Survey” in the subject.

Customer or Agency Name:

Name:

Position/Title:

Email Address:

Phone (DSN): ______ (Commercial)

Fax (DSN): ______ (Commercial)

Contracting Officer Name

Contracting Officer Email Address:

Phone (DSN): ______ (Commercial)

Other suggested points of contact:

Contract Performance Data assessed in Contractor Performance Assessment Reporting System (CPARS):

_______ Yes or ______No

Give a brief, general description of what the contractor was required to provide/deliver.

REMARKS: ___________________________________________________________________________ mailto:melinda.j.lewis9.civ@mail.mil mailto:david.m.hoag.civ@mail.mil

SECTION 3: PERFORMANCE INFORMATION

INSTRUCTIONS: Choose the term that most accurately describes the contractor’s performance or situation. Please provide concise comments regarding your overall assessment of the contractor’s performance on the contract or workload identified below. Your ratings should include comments for any area rated Exceptional or lower than Satisfactory. Remarks may be continued on separate pages (please identify category and question number).

The results of this survey will aid the Government in determining whether there is a reasonable expectation that the contractor will successfully perform the required effort under the GTMO acquisition.

In responding to the survey, please justify and explain Marginal, and Unsatisfactory ratings.

Respondent may be contacted to clarify comments or ratings. In order for the government to review and assess the contractor’s past performance rating, please use the following ratings to describe the offeror’s performance on your contract or project:

Exceptional - Performance met all contract requirements and exceeded many to your company’s (or agency’s) benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

Very Good - Performance met all contract requirements and exceeded some to your company’s (agency’s) benefit. There were a few minor problems that the contractor resolved in a timely, effective manner.

Satisfactory - Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

Marginal - Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective or was not fully implemented.

Unsatisfactory - Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.

N/A - No record of past performance or the record is inconclusive.

NOTE: If you have rated this contractor on this particular contract or project in CPARS or some other evaluation system accessible to the Government, you may indicate that past performance information on this contract/project is available in the appropriate system and you may include a copy of that rating in lieu of the following questionnaire.

1. Technical Capability – On Time Delivery

a. Contractor provided on-time delivery of shipments and consistently met contract schedule.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

b. Contractor provided operational reports in a timely manner.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

2. Technical Capability – Timeliness/Accuracy of Electronic Data Interchange Transmissions

a. Contractor was capable of electronically receiving orders, including increased/decreases to orders.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

b. Contractor was able to receive electronic cancellations of previously ordered service.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

c. Contractor provided accurate & timely shipment status reports.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

3. Technical Capability – Consistency and Reliability of Service

a. Contractor provided service per advertised schedules.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

b. Contractor provided service to ports of call indicated in their advertised schedule without deviation.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

c. Contractor provided frequency of service as advertised in their schedules.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

d. Contractor was flexible in responding to customer requirements

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

4. Technical Capability – Loss of and/or Damage to Shipments

a. Contractor provided transportation service without loss of cargo

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

b. Contractor provided transportation service without damage to cargo.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

5. Overall Performance

a. Overall Performance of the contractor.

Exceptional____Very Good____Satisfactory____Marginal____Unsatisfactory____N/A____

REMARKS:

6. Would you award to this contractor in the future?

Yes ___________ No___________

If “No”, why?

Any additional comments:

Fax (DSN): U______ U (Commercial)

Contractor CompanyDivision:
Contract NumberType FFP CPFF etc:
Work Performed Title:
containerized shipped under this contract total number of voyages and location of service performed 1:
containerized shipped under this contract total number of voyages and location of service performed 2:
containerized shipped under this contract total number of voyages and location of service performed 3:
containerized shipped under this contract total number of voyages and location of service performed 4:
containerized shipped under this contract total number of voyages and location of service performed 5:
containerized shipped under this contract total number of voyages and location of service performed 6:
containerized shipped under this contract total number of voyages and location of service performed 7:
containerized shipped under this contract total number of voyages and location of service performed 8:
containerized shipped under this contract total number of voyages and location of service performed 9:
containerized shipped under this contract total number of voyages and location of service performed 10:
containerized shipped under this contract total number of voyages and location of service performed 11:
containerized shipped under this contract total number of voyages and location of service performed 12:
Overall Dollar value:
Period of Performance:
Did you serve as the:
Prime or:
service was provided:
Customer or Agency Name:
Name:
PositionTitle:
Email Address:
Commercial_2:
Contracting Officer Name:
Contracting Officer Email Address:
Commercial_3:
Other suggested points of contact 1:
Other suggested points of contact 2:
undefined:
Yes or:
REMARKS 1:
REMARKS 2:
REMARKS 3:
REMARKS 4:
REMARKS 5:
REMARKS 6:
REMARKS 7:
REMARKS 8:
REMARKS 9:
Exceptional:
Very Good:
Satisfactory:
Marginal:
Unsatisfactory:
NA:
REMARKS 1_2:
REMARKS 2_2:
REMARKS 3_2:
Exceptional_2:
Very Good_2:
Satisfactory_2:
Marginal_2:
Unsatisfactory_2:
NA_2:
REMARKS 1_3:
REMARKS 2_3:
REMARKS 3_3:
Exceptional_3:
Very Good_3:
Satisfactory_3:
Marginal_3:
Unsatisfactory_3:
NA_3:
REMARKS 1_4:
REMARKS 2_4:
REMARKS 3_4:
Exceptional_4:
Very Good_4:
Satisfactory_4:
Marginal_4:
Unsatisfactory_4:
NA_4:
REMARKS 1_5:
REMARKS 2_5:
REMARKS 3_5:
Exceptional_5:
Very Good_5:
Satisfactory_5:
Marginal_5:
Unsatisfactory_5:
NA_5:
REMARKS 1_6:
REMARKS 2_6:
REMARKS 3_6:
Exceptional_6:
Very Good_6:
Satisfactory_6:
Marginal_6:
Unsatisfactory_6:
NA_6:
REMARKS 1_7:
REMARKS 2_7:
REMARKS 3_7:
Exceptional_7:
Very Good_7:
Satisfactory_7:
Marginal_7:
Unsatisfactory_7:
NA_7:
REMARKS 1_8:
REMARKS 2_8:
REMARKS 3_8:
Exceptional_8:
Very Good_8:
Satisfactory_8:
Marginal_8:
Unsatisfactory_8:
NA_8:
REMARKS 1_9:
REMARKS 2_9:
REMARKS 3_9:
Exceptional_9:
Very Good_9:
Satisfactory_9:
Marginal_9:
Unsatisfactory_9:
NA_9:
REMARKS 1_10:
REMARKS 2_10:
REMARKS 3_10:
Exceptional_10:
Very Good_10:
Satisfactory_10:
Marginal_10:
Unsatisfactory_10:
NA_10:
REMARKS 1_11:
REMARKS 2_11:
REMARKS 3_11:
Exceptional_11:
Very Good_11:
Satisfactory_11:
Marginal_11:
Unsatisfactory_11:
NA_11:
REMARKS 1_12:
REMARKS 2_12:
REMARKS 3_12:
Exceptional_12:
Very Good_12:
Satisfactory_12:
Marginal_12:
Unsatisfactory_12:
NA_12:
REMARKS 1_13:
REMARKS 2_13:
REMARKS 3_13:
Yes:
No:
If No why 1:
If No why 2:
If No why 3:
If No why 4:
Any additional comments 1:
Any additional comments 2:
Any additional comments 3:
Any additional comments 4:
Any additional comments 5:
Any additional comments 6:
Any additional comments 7:
Commercial:

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