Attachment 9 PPQ Worksheet.docx

47QFWA21Q0046

Course Development and Delivery Services

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

INSTRUCTIONS TO OFFERORS SUBMITTING PAST PERFORMANCE QUESTIONNAIRES:

All sections must be completed by the Offeror. The Offeror must submit the questionnaires for relevant projects that are in progress or completed in the past three (3) years. GSA will be attempting to contact the Third Party POCs to verify the information provided in the self-assessment. It is the responsibility of the Offeror to provide accurate contact information for GSA to use when contacting the third party POCs. The completed questionnaires shall be included in Volume VI of the Offeror’s proposal.

The Offeror must submit a total of two separate questionnaires.

Offerors must use the document included in Attachment 10 for the submission of their proposal to meet the requirements of Past Performance.

Sincerely, LISA M. RICHE

Contracting Officer

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM SUBMITTING PROPOSAL)

PART I: OFFEROR INFORMATION

COMPANY / BUSINESS NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS DESCRIBED:

PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):

TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID):

PRICING TYPE: (Check all that apply) |_| FP |_| FP-EAP |_| CPFF-Completion |_| CPFF-Term |_| CPIF |_| CPAF |_| ID/IA |_| BOA

|_| Requirements |_| Labor-Hour |_| T&M |_| CR |_| Other (Specify) _______________

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

· INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

· FINAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

ROLE ON PROJECT:

|_| PRIME

|_| SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF APPLICABLE):

|_| OTHER (EXPLAIN)

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE SCOPE AND COMPLEXITY OF WORK:

SECTION B

PART I: PROJECT REFERENCE INFORMATION “THIRD PARTY FIRM”

NAME & TITLE OF THIRD PARTY INDIVIDUAL INDENTIFIED AS POINT OF CONTACT:

ORGANIZATION OF THIRD PARTY FIRM (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE OF THIRD PARTY P.O.C. (e.g. CO, COR, PM):

WORK ADDRESS OF THIRD PARTY P.O.C.:

PHONE NUMBER OF THIRD PARTY P.O.C.:

E-MAIL OF THIRD PARTY P.O.C.:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

This is an objective self-assessment of the work performed on a past contract between your firm and a Third Party Firm. The rating for each Performance Element should represent the results and outcomes for the work performed on a past contract and how well you performed. GSA will try to contact and verify all information with the “Third Party” to ensure consistency of the information provided.

Provided below are the definitions for the ratings of the performance elements. Please objectively assess each Performance Element as it related to the referenced contract.

Place an “X” to the most appropriate rating in the table below:

· Excellent (The work performed significantly exceeded the minimum requirements of the contract. There was a very low risk of unsuccessful performance of the contract. Very little to no oversight was required in achieving the required level of contract performance.)

· Very Good (The work performed exceeded to some degree some of the minimum requirements of the contract. There was a low risk of unsuccessful performance of the contract. Little to moderate oversight was required in achieving the required level of contract performance.)

· Acceptable (The work performed met the minimum requirements of the contract. There was a low to moderate risk of unsuccessful performance of the contract. Little to very little oversight was required in achieving the required level of contract performance.)

· Marginal (The work performed did not meet to some degree some of the minimum requirements of the contract. There was a high risk of unsuccessful performance of the contract. Moderate oversight was required in achieving the required level of contract performance.)

· Unacceptable (The work performed did not meet a majority, or any of the minimum requirements of the contract. There was a very high risk of unsuccessful performance of the contract. Substantial oversight was required in achieving the required level of contract performance. )

PERFORMANCE ELEMENT SELF ASSESSMENT FOR PAST CONTRACT

Clearly Mark the Appropriate Rating for Each Performance Element

Performance Element

Excellent

Very Good

Acceptable

Marginal

Unacceptable

1. QUALITY OF SERVICE

Assess the performance to contract requirements, specifications, and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).

2. SCHEDULE

Assess the timeliness against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or effect the schedule variance).

3. COST CONTROL

Assess the effectiveness in forecasting, managing, and controlling cost. (e.g. Did Contractor stay on budget and on time with minimal delays?)

4. BUSINESS RELATIONS

Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontractors.

5. MANAGEMENT OF KEY PERSONNEL

Assess the performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

FOR #6, PLEASE ANSWER “Yes” or “No”, as appropriate

6. Given the choice, would the Third party firm hire you again to do similar work?

7. Additional comments you would like to share.

Past Performance Questionnaire