Atch 7 Past Performance Questionnaire.pdf

Attachment 7 Past Performance Questionnaire

HTC71120RW001

Version 1

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

A. Contractor Name on Awarded Contract: _________________________________________________________

B. Contractor (e.g., Prime, Affiliate, Subsidiary, or Subcontractor) Performing Services: _____________________

C. Contract Number: _________________________________________________________________

D. Contract type: __________________________________________

E. Period of performance: _________________________________________________

F. Initial Contract cost: $____________________________

G. Final Contract cost: $____________________________

H. Explain the reasons for differences between initial contract cost and final contract costs:

I. Explain the process utilized to ensure a clean barge was provided to the customer. Define your cleaning standards and process.

J. Provide monthly number of gallons of cargo and type of fuel(s) transported to and between the points stipulated to destination:

K. Provide monthly number of deliveries of cargo and type of fuel(s) transported to and between the points stipulated to destination:

L. Provide an all-inclusive listing of countries, if only U.S.A performance please list states, where service was performed under this contract:

SECTION 1: CONTRACT IDENTIFICATION

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

M. Contractor being evaluated performed as the: __ Prime __Affiliate __Subsidiary __Subcontractor (Mark one)

N. Identify the Prime contractor’s role during performance if contract performance was accomplished by an affiliate, subsidiary or subcontractor.

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: rachel.l.dow.civ@mail.mil; sarah.l.albers2.civ@mail.mil.. Please indicate “Performance Survey” in the subject.

A. Customer or agency name: ____________________________________________________

B. Respondent's name: _________________________________________________________

C. Respondent's title: __________________________________________________________

D. Respondent's phone/fax number: ______________________________________________

E. Respondent’s Email: ________________________________________________________

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

________Yes or ________No

H. Contractor requesting Past Performance Questionnaire Completion: _______________________

SECTION 3: PERFORMANCE INFORMATION

INSTRUCTIONS: Choose the term that most accurately describes the contractor’s performance or situation.

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 Scheduled Fuel Barge in the Gulf Region 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.

mailto:joegino.m.pereyra.civ@mail.mil

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

Unknown - 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.

TECHNICAL CAPABILITY

U ns at is fa ct or y

M ar gi na l

Sa tis fa ct or y

V er y G oo d

E xc ep tio na l

U nk no w n

A Contractor’s performance providing fuel transportation via inland waterway barges.

B Contractor’s performance providing fuel transportation along the United States Coastlines, specifically Gulf Coasts.

C Contractor’s performance providing fuel transportation via multiple tugs and barges.

D Contractor’s performance providing tug and barge transportation to various locations.

E Contractor’s performance loading, transporting and discharging fuel safely, timely and free of contamination via tug and barge.

F Contractor’s performance meeting customers Required Delivery Date (RDD).

G Contractor’s equipment was provided clean and free of contaminants.

OVERALL PERFORMANCE

U ns at is fa ct or y

M ar gi na l

Sa tis fa ct or y

V er y G oo d

E xc ep tio na l

U nk no w n

A. Overall Performance of the contractor

SECTION 4: NARRATIVE DESCRIPTION

1. Please discuss each and every response for which you indicated Marginal or Unsatisfactory in response to the questions above (use additional sheets, if necessary).

2. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? YES________ NO________

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.)

3. Explain the contractor’s greatest strengths and your rationale for why you would award a future contract to them.

4. Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

5. Please provide any additional comments concerning this contractor’s performance, as desired.