Attachment II_Past-Performance-Questionnaire-GUARD.pdf

HU0001-11-R-1428

ATTACHMENT II

Source Selection Information – See FAR 2.101 and FAR 3.104

For Official Use Only

Past Performance Questionnaire

Instructions:

Sections II to be completed by the Offeror/Major Subcontractor and provided to the assessor

(Government personnel that had experience with the Offeror/Major Subcontractor on a previous relevant contract). The assessor, in turn, to verify Sections I through III, complete the questionnaire, and submit to the Contracting Office. The Offeror should also submit with its proposal (by the closing date of the Solicitation) copies of Sections I and II of all questionnaires as provided to assessors.

Section II to be validated by the assessor. If any information is incorrect herein, please annotate and provide the correct information accordingly.

Sections III through VII to be completed in their entirety by the assessor.

Message to the assessor: Your assistance is requested by the Uniformed Services University of the Health

Sciences (USUHS) to assist with establishing the performance history for the Contractor named below. In efforts to expedite receipt of the requested information, the Contracting Office respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to Christina Johnson at cjohnson@usuhs.mil or fax to 301-295-1716.

I. Solicitation Data (for the proposed effort)

Solicitation Number HU0001-11-R-1428

Project/Requirement Unarmed Guard Services

Customer/Agency Uniformed Services University of the Heath Sciences (USUHS)/Directorate of Contracting

Project/Requirement

Description

Past Performance Questionnaire

II. Current or Historical Contract Information

Assessor: The performance data submitted by the Offeror is correct or incorrect.

CONTRACTOR NAME &

ADDRESS:

Contract No

Type of Contract

Initial Final

Contract Value

Period of

Performance/Delivery

Schedule

Project/Requirement

Description

Please select from the following as it applies to this contract:

Contracting Role PRIME

JOINT

VENTURE

SUBCONTRACTOR

OTHER

Percent of project work performed:

If subcontractor, who was prime (Name/Phone #):

Termination

History

Convenience Default N/A

III. Assessor Information

Assessor Name

Title

Phone Number/Email Address

Identify your role in the contract award or administration and the period of your involvement.

Role Period of Involvement

Procuring Contracting Officer (PCO)

Administrative Contracting Officer (ACO)

Contract Specialist

Contracting Officer’s Representative (COR)

Technical Project Lead/Project Officer

Quality Assurance Specialist

Defense Contract Audit Agency (DCAA)

Auditor

Other:

IV. Evaluation Definitions

The following definitions should be used in your assessment of Contractor performance.

EXCEPTIONAL

Performance EXCEEDS MOST contractual requirements to the

Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

Performance EXCEEDS SOME contractual requirements to the

Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the

Contractor’s corrective actions were highly effective.

SATISFACTORY

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE

(N/A)

Performance information not recent or relevant as defined in the

Solicitation. Unable to provide assessment.

PLEASE CIRLCE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUTAION OF THE CONTRACTOR’S PERFORMANCE.

1. Ability to meet quality standards specified for technical performance. E V S M U N

2. Compliance with contractual terms and conditions.

E V S M U N

3. Compliance with contract delivery/completion schedules including any significant intermediate milestones. E V S M U N

4. Quality/integrity of technical data/report preparation efforts. E V S M U N

5. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements. E V S M U N

6. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program). E V S M U N

7. Effectiveness of on-site management, including management of subcontractors? E V S M U N

8. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports).

E V S M U N

9. Timeliness/effectiveness of contract problem resolution without extensive customer guidance. E V S M U N

10. Ability to successfully respond to emergency and/or surge situations. E V S M U N

11. Effectiveness of material management.

E V S M U N

12. Effectiveness of acquisition management.

E V S M U N

13. Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client. E V S M U N

14. Contractor’s management of their safety program.

E V S M U N

15. Responsiveness regarding safety issues.

E V S M U N

16. If this was a cost type contract, compliance with established budgets and avoidance of significant and/or unexplained variances (underruns or overruns). E V S M U N

17. If this is/was a Government cost type contract, the

Contractor’s timeliness in submitting monthly invoices with appropriate back-up documentation and monthly status reports/budget variance reports.

E V S M U N

18. If this is/was a Government cost type contract, the

Contractor’s accuracy regarding monthly invoices with appropriate back-up documentation and monthly status reports/budget variance reports.

E V S M U N

19. Ability to hire/apply a qualified workforce to this effort.

E V S M U N

20. Ability to retain a qualified workforce on this effort.

E V S M U N

21. If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

Yes No

22. Have there been any indications that the contractor has had any financial problem? If yes, please explain below. Yes No

23. In summary, provide an overall rating for the work performed by this contractor. E V S M U N

Any additional comments related to the contractor’s performance:

Assessor’s Signature Date