Attachment_5_-_Past_Performance_Questionnaire.pdf

HTC711-18-R-W002

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 quantities, monthly or annually, by breakbulk and containers 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: megan.m.isaak.civ@mail.mil and christoper.t.frost4.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:megan.m.isaak.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.

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

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

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

c. Contractor provided accurate & timely shipment status reports.

3. Technical Capability – Consistency and Reliability of Service

a. Contractor provided service per advertised schedules.

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

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

d. Contractor was flexible in responding to customer requirements

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

a. Contractor provided transportation service without loss of cargo

b. Contractor provided transportation service without damage to cargo.

5. Overall Performance

a. Overall Performance of the contractor.

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

Yes ___________ No___________

If “No”, why?

Any additional comments:

Fax (DSN): ______ (Commercial)