M67001-16-T-0005_Attachment_4.pdf

M67001-16-T-0005 Attachment 4 PAST PERFORMANCE QUESTIONNAIRE

M67001-15-T-0200

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

For Official Use Only

Instructions:

A. Sections I has been completed by the Contract Specialist.

B. Section II through III shall be completed by the Quoter and provided to the assessor (Government or other personnel who had experience with the Offeror/Major Subcontractor on a previous relevant contract). The assessor, in turn, to verify Sections II through III, complete the questionnaire, and submit to the

Contracting Office. The Offeror should also submit with its quote (by the closing date of the Solicitation) copies of Sections I and II of all questionnaires as provided to assessors.

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

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

Message to the assessor: Your assistance is requested by the USMC 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) no later than 24 November 2015 at 11:300 am EST to: tracy.fulks@usmc.mil or fax to 910-451-2193. POC Tracy

Fulks, 910-451-1256

I. Solicitation Data (for the proposed effort)

Solicitation Number M67001-16-T-0005

Project/Requirement Washer and Dryer Maintenance and Repair

Customer/Agency MCIEAST-MCB Camp Lejeune Contracting Dept, USMC

Project/Requirement

Description

Provide all management, tools, supplies, equipment and labor necessary to maintain and repair Government owned washers and dryers at the buildings located on Marine

Corps Base (MCB) Camp Lejeune, Marine Corps Air Station (MCAS) New River, Camp Geiger, Camp Johnson, Courthouse Bay and Stone Bay, North Carolina

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 SUBCONTRACTOR

Termination History Convenience Default

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.

V. Performance Evaluation

1. Quality of Performance

a. What is your OVERALL assessment of the quality of the contractor’s performance?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Quality of

Performance

Please provide rationale for the assigned rating.

b. Assess the Contractor’s quality of performance in the following areas.

Conformance to

Contract

Requirements

Conformance to

Specifications

Standards of

Good

Workmanship

(technical, professional, environmental, safety, etc.)

All comments are appreciated; however, at a minimum, rationale must be provided for ratings of exceptional or unsatisfactory.

c. Did the Government contribute in any way to problems associated with quality as identified in the above assessment? Please explain.

2. Schedule Performance

a. What is your OVERALL assessment of the Contractor’s ability to meet the schedule?

Please provide rationale for assigned rating.

b. Assess the Contractor’s Schedule Performance in the following areas.

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Timeliness in

Completion of

Contract/Task

Order/Delivery

Timeliness in

Meeting

Milestones

Timeliness in

Submitting

Deliverables

All comments are appreciated; however, at a minimum, rationale must be provided for ratings of exceptional or

c. Did the Government contribute in any way to any of the Schedule problems identified in the above assessment?

Please explain.

3. Management Performance

a. What is your OVERALL assessment of the Contractor’s management performance?

Management

b. Assess the Contractor’s management performance in the following areas.

Management Performance Exceptional Very

Satisfactory Marginal Unsatisfactory N/A

MANAGEMENT

RESPONSIVENESS—

(timeliness, completeness, and quality of problem identification, proposal submittal, history of cooperative behavior, effective business relations, teamwork

AND customer satisfaction)

SUBCONTRACT

MANAGEMENT—(timely award and management of subcontracts and meeting subcontracting goals for small business, small disadvantaged business, etc)

PROGRAM

MANAGEMENT—

(effectiveness of integration and coordination of all activities required to execute the contract, use of resources, assignment of responsibility, internal coordination and communication, and risk management practices)

MANAGEMENT OF

PERSONNEL—(ability to select, retain, support, and replace personnel with the experience and expertise necessary to accomplish the

Government’s requirements within schedule and budget)

INTEGRATED PRODUCT

TEAM MANAGEMENT—

(commitment and participation to the IPT process)

All comments are appreciated; however, at a minimum, rationale must be provided for ratings of exceptional or

c. Did the Government contribute in any way to any of the management problems identified in the above assessment? Please explain.

4. Cost Control

a. What is your OVERALL assessment of the Contractor’s ability to forecast, manage, and control costs?

Cost Control

b. Assess the Contractor’s cost performance in the following areas.

COST CONTROL Exceptional Very

Satisfactory Marginal Unsatisfactory N/A

COST/PRICE ESTIMATES—

(ability to meet proposed costs and whether actual costs/rates realized reflect negotiated costs/rates)

COST EFFICIENCIES—

(realization of any in accomplishing SOW)

INVOICING—accuracy and timeliness of submission

FORECASTING/MANAGEM

ENT/COST CONTROL

All comments are appreciated; however, at a minimum, rationale must be provided for ratings of exceptional or

VI. Overall Rating of Contractor’s performance (technical, schedule, management, and cost) on contract being assessed.

Exceptional Very Good Satisfactory Marginal Unsatisfactory

VII. General Comments:

Assessor’s printed name & Signature Date