Plans_Data_Support_Past_Performance_Questionnaire.docx
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- Solicitation number
- M67004-15-R-0028
- Issued by
-
United States Marine Corps
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Plans and Data Support Past Performance Questionnaire
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M67004-15-R-0028 Blount Island Command, Jacksonville, Flordia 32226 Plans & Data Support Services
SUBJECT: Past Performance Evaluation Form for ____________________; Request for Proposal (RFP) Number M67004-15-R-0028
Dear Sir or Madam:
You are requested to answer the attached Past Performance Questionnaire in response to a solicitation issued by the United States Marine Corps, Blount Island Command, jacksonville, Florida 32226. It is stressed that this questionnaire be filled out by the addressee and not the Offeror, and that the information then forwarded to the Government individual identified below. The addressee is requested to sign the questionnaire as a validation of the assessment.
RESPONDENT: DO NOT RETURN YOUR RESPONSE TO THE CONTRACTOR THAT FORWARDED THIS QUESTIONNAIRE TO YOU.
This letter, as well as the attached questionnaire, has been forwarded to you by _____________ (insert name of firm/offeror). This firm intends to submit a proposal as either a prime Contractor or a Subcontractor in response to Solicitation M67004-15-R-0028 for Plans & Data Support Services. This company has been instructed to forward this correspondence to you for assessment of its past performance. Please complete the questionnaire and email it to the following email address NLT the proposal due date: _________(TBD)
A member of our evaluation group may be in contact with you regarding your response should it become necessary. In the event that your response contains derogatory or superlatively positive responses/comments regarding the Contractor’s performance, you are requested to discuss your response and submit available documentation supporting these assessments. Your submittal of such documentation will hopefully eliminate post-response inquiries.
If you have any questions about this form or the overall past performance process, please contact the undersigned at joanna.lovett-black@bic.usmc.mil. Your cooperation in this matter is greatly appreciated.
Sincerely,
| JoAnna Lovett-Black |
| Contracting Officer |
Encl
| ________________________________ | _________________________ | |
| Signature of Offeror | Title |
| ________________________________ | _________________________ | |
| Typed or Printed Name | Date |
PAST PERFORMANCE QUESTIONNAIRE
TO REFERENCE: (Enter name of reference entity the questionnaire is being sent to)
REFERENCE’S PHONE NUMBER:
REFERENCE’S EMAIL:
FROM REQUESTING FIRM:
(Name of Firm and contact information of the person requesting the accomplishment of the questionnaire.)
Your assistance is requested in support of a source selection. The USMC Blount Island Command is in the process of soliciting offers from companies capable of providing Plans and Data Support Services. [Our firm] has provided your name and organization as a reference regarding our record of past performance under Contract No. [CONTRACT NO.].
Please complete this Questionnaire and forward a PDF copy to JoAnna Lovett-Black, Contracting Officer, at joanna.lovett-black@bic.usmc.mil.
[Our firm] is competing for Solicitation #M67004-15-R-0028 as a:
Prime Contractor
| Subcontract to (please identify the Prime Contractor under which you will |
| compete for the contract awards): |
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.
SECTION I - TO BE COMPLETED BY OFFEROR
1. CONTRACTOR NAME & ADDRESS:
2. CONTRACT NO.:
3. CAGE CODE:
4. PERIOD OF PERFORMANCE:
5. COMPETITIVELY AWARDED (circle one) YES or NO
6. INITIAL CONTRACT VALUE (with options): $
7. CURRENT CONTRACT VALUE (with options): $
8. TYPE OF CONTRACT:
9. REASONS FOR DIFFERENCE (IF ANY) BETWEEN INITIAL CONTRACT VALUE AND CURRENT CONTRACT VALUE:
10. DESCRIPTION OF CONTRACT REQUIREMENTS:
Please add a continuation page if additional space necessary.
SECTION II - EVALUATION - TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
| 11. CUSTOMER OR AGENCY NAME (AND DESCRIPTION): |
| 12. EVALUATOR’S NAME: |
13. EVALUATOR’S TITLE:
14. EVALUATOR’S PHONE NUMBER:
15. EVALUATOR’S EMAIL ADDRESS:
16. NUMBER OF YEARS OR MONTHS EVALUATOR HAS MONITORED CONTRACTOR’S PERFORMANCE:
17A. INDIVIDUAL RATINGS EVALUATION:
Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:
CODE PERFORMANCE LEVEL
E EXCEPTIONAL - Quality of performance exceeded all contractual requirements and expectations. The contract performance specification was accomplished with only minor problems for which corrective actions taken by the contractor were highly effective. The contractor was pro-active in identification of problems, providing alternatives and recommendations.
VG VERY GOOD - Quality of performance met contractual requirements and exceeded many expectations. The contract scope of work was accomplished with some minor problems for which corrective actions taken by the contractor were highly effective.
S SATISFACTORY – Quality of performance met contractual requirements. The contract scope of work was accomplished with some problems for which corrective actions taken by the contractor were satisfactory.
M MARGINAL – Quality of performance did not meet some contractual requirements. The contract scope of work had some serious problems which the contractor did not resolve to the customer’s satisfaction. The contractor’s proposed corrective actions appeared to be only marginally effective or were not fully implemented by the contractor.
U UNSATISFACTORY – Quality of performance did not meet most contractual requirements and recovery is not likely in a timely manner. The contract scope of work performance had major problems for which the contractor’s corrective actions were ineffective.
NA NOT APPLICABLE - Unable to provide a score as the question does not apply.
| Technical Performance |
| E |
| VG |
| S |
| M |
| U |
| NA |
T1. Quality of Product or Service. Ability of Contractor to: provide accurate deliverables/reports; meet service specifications of the contract; provide timely proposals; respond to short notice requirements; provide and adhere to quality control/management plan (when required)
T2. Schedule. Ability of Contractor to provide deliverables/reports required by the contract on time
T3. Cost/Price Control. Ability of Contractor to: provide accurate contract costs/estimates; track and control costs; meet and perform within negotiated costs; provide current, accurate and complete invoices/billing; submit cost reporting information in a timely manner
T4. Outside the Continental United States (OCONUS) Support. Ability of Contractor to: obtain and retain required clearances and documentation for OCONUS performance; adhere to applicable guidance, instructions, directives for OCONUS performance.
| Technical Performance |
| E |
| VG |
| S |
| M |
| U |
| NA |
T5. Business Relations. Ability of Contractor to: maintain effective relationship between key Contractor personnel and key Government personnel; manage, resolve problems and respond to and/or integrate changes in mission-related requirements
T6.
T7.
T8
T9.
T10.
T11.
T12
T13
T14
| Management Capability |
| E |
| VG |
| S |
| M |
| U |
| NA |
M1. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)
M2. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)
M3. Timeliness/effectiveness of contract problem resolution without extensive customer guidance
M4. Understand/complied with customer objectives and technical requirements
M5. Successfully responded to emergency and/or surge situations
M6. Quality/effectiveness of sub-contracted efforts
M7. Effectiveness of material management (including Government Furnished Property, Information, or Material)
M8. Effectiveness of acquisition management
M9. Contractor proposed alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the customer
M10. Contractor implemented responsive/flexible processes to improve quality and timeliness of support.
M11. Successfully managed an integrated team inclusive of subcontractors/teammates.
M12. The Contractor’s management plans met the customer’s requirements and resulted in efficient, effective and adaptable program planning and execution
M13. Obtained and updated the human knowledge capital required for successful contract execution
M14. Retained Key Personnel, staff and subcontractors with sufficient qualifications, experience and had successful methods for accommodating changes in staffing levels in a dynamic environment which yielded efficient, effective and adaptable planning and execution of the program
M15. Successfully recruited and retained employees qualified for the effort
| Transition/phase-in |
| E |
| VG |
| S |
| M |
| U |
| NA |
T1. Phase-In
T2. Phase-Out
| Small and Small Disadvantaged Business Participation |
| E |
| VG |
| S |
| M |
| U |
| NA |
S1. Ability to meet or exceed small business and small disadvantaged business goals set forth in the approved subcontracting plan.
S2. Ability to effectively manage small business participation to meet technical performance.
| Cost Performance |
| E |
| VG |
| S |
| M |
| U |
| NA |
C1 Accuracy in forecasting contract costs
C2 Demonstrated ability to meet forecasted costs and perform within contract costs
C3 Demonstrated ability to alert Government of unforeseen costs before they occur
C4 Sufficiency and timeliness of cost reporting
17B. Please discuss each response for which you indicated E (Exceptional), M (Marginal) or U (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).
18. OVERALL EVALUATION RATING (circle one):
Overall Assessment: (a) EXCEPTIONAL (b) VERY GOOD (c) SATISFACTORY (d) MARGINAL (e) UNSATISFACTORY (f) NOT OBSERVED
19. Any unsatisfactory performance identified above has been shared with the contractor. ( ) Yes: written or oral ? ( ) No
20. Government Contracts ONLY: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?
Yes___ Default___ Convenience___ Pending Terminations___ No ___
If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).
21. Would you have any reservations about soliciting this Contractor in the future or having them perform one of your critical and demanding programs?
Yes___ No ___
If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).
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