Attachment_5_Past_Performance_Questionnaire_ID04180070__1_Jun_2018.docx

ATTACHMENT 5

Past Performance Rating for GSA Task Number ID04180070 Project Title: Joint Cyber Planning Services Source Selection Information – See FAR 2.101 and 3.104

Thank you in advance for filling out this questionnaire for the U.S. General Services Administration (GSA) on behalf of USCENTCOM. We understand that your time is very valuable and we appreciate your input.

Please provide your candid responses. The following questions pertain to the contractor’s record of past (within the past five (5) years) and/or current performance. Please email the completed questionnaire to the following personnel:

· keith.echols@gsa.gov, GSA Contracting Officer

· sara.davila@gsa.gov, GSA Contract Specialist

The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluator(s). Please provide examples and/or explanations (use additional pages if necessary). If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does and inform the sender.

PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Name:

Role on Contract: (Prime/Subcontractor):

2. Contract Number:

____Firm Fixed Price

____T&M/LH

____Cost Reimbursement ____Other (Please Specify)

7. Period of Performance (including options):

8. Dollar Amount of Award: $______________ Annual Amount: $______________ Total Dollar Value with Mods:$_____________ # of FTE:

If your firm was a subcontractor or team member:

Annual Amount: $______________ Total Dollar Value with Mods:$_____________ # of FTE: ____________

9. Project Title:

10. Description of Contract Service/Scope of Contract:

11. Complexity of Work: Difficult: ____________ Routine: ____________

NOTE: Please use adjectival ratings from attached sheet.

a. Quality of Work

COMMENTS ARE HIGHLY ENCOURAGED for all ratings/ MANDATORY FOR RATING OF EXCEPTIONAL & UNSATISFACTORY

b. Personnel

COMMENTS ARE HIGHLY ENCOURAGED for all ratings/ MANDATORY FOR RATING OF EXCEPTIONAL& UNSATISFACTORY

c. Cost/Budget Control

COMMENTS ARE HIGHLY ENCOURAGED for all ratings/ MANDATORY FOR RATING OF EXCEPTIONAL & UNSATISFACTORY

d. Customer Satisfaction

COMMENTS ARE HIGHLY ENCOURAGED for all ratings/ MANDATORY FOR RATING OF EXCEPTIONAL & UNSATISFACTORY

f. Management

COMMENTS ARE HIGHLY ENCOURAGED for all ratings/ MANDATORY FOR RATING OF EXCEPTIONAL & UNSATISFACTORY

15. Would you select this contractor again? Please explain. (Attach additional sheet if necessary.)

16.

Name: __________________________________

Signature:________________________________ Date:________________

17. Title:___________________________

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Marginal, Satisfactory, Very Good, and Exceptional. Use the following instructions as guidance in making these evaluations. Please use the comments area on the preceding form to justify the rating given.

Personnel/Service

-Compliance w/contract requirements -Accuracy of reports -Appropriateness of personnel -Technical excellence

Cost/Budget Control

-Within budget -Current, accurate, complete billings -Relationship of negotiated costs to actual -Cost efficiencies -Change orders issued Customer Satisfaction

Customer Satisfaction is a measure of how products and services supplied by a company meet or surpass customer expectation.

On a scale of 1-5 (5 being the highest) please rate and describe your level of satisfaction with the contractor’s performance.

5 - Very satisfied

4 - Somewhat satisfied

3 - Neither satisfied nor dissatisfied

2 -Somewhat dissatisfied

0 - Very dissatisfied

Timeliness of Services/Deliverables

-Met interim milestones -Reliable -Responsive to technical direction -Completed on time Management

-Effective Mgmt -Business like correspondence -Responsive to contract reqmnts -Prompt notification of problems -Reasonable/ cooperative -Flexible -Pro-active

are comprising the achievement of contract reqmnts Cost issues are comprising performance

do not impact achievement of contract reqmnts Cost issues do not impact achievement of contract reqmnts

Exceptional The contractor has demonstrated an exceptional performance level that was significantly in excess of anticipated achievements and is commendable as an example for others. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".

The contractor has demonstrated an exceptional performance. It is expected that this rating will be used in those rare circumstances where the contractor achieved cost savings and performance clearly exceeds the performance levels described as "Exceptional".

The contractor has demonstrated an exceptional performance level. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".

The contractor has demonstrated an exceptional performance level. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Exceptional".

SOURCE SELECTION SENSITIVE INFORMATION – PROTECT IAW FAR 2.101 & 3.104