17R1217_Attachment_07_(Past_Performance_Questionnaire).pdf

M67854-17-R-1217 Attachment 07

Source Selection Information—See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

PAST PERFORMANCE QUESTIONNAIRE

SECTION I: TO BE COMPLETED BY THE OFFEROR

Company Name:

Contract Number:

Contract Period of Performance:

Total Contract Value:

Contract Type:

Description of Contract Requirements:

Procuring Contracting Officer (PCO):

Name:

Email:

Phone:

Contracting Officer Representative (COR)/Technical Representative):

Name:

Email:

Phone:

Administrative Contracting Officer (ACO):

Name:

Email:

Phone:

SECTION II: TO BE COMPLETED BY CUSTOMER AGENCY

Organization Name:

Evaluator Name and Title:

Evaluator Signature:

Evaluator Phone Number and Email:

SECTION III: INSTRUCTIONS FOR CUSTOMER AGENCY COMPLETION OF PAST

PERFORMANCE QUESTIONNAIRE:

The company that has sent you this form is responding to a Marine Corps Systems Command solicitation for USMC Pack Requirement. Your assistance is requested in providing input on the past performance of the offeror on the contract identified in Section I. Please complete the attached questionnaire using the following guidance and email it to keane.butts@usmc.mil prior to 22 May 2017. Questions may be addressed to Mr. Butts via email or by phone at (703) 784- 4898.

mailto:keane.butts@usmc.mil

Source Selection Information—See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

Indicate, the company’s performance on the identified contract using the evaluation ratings and definitions below. Handwritten responses are sufficient. Assessments will be used in the potential award of a defense contract. If you do not have the appropriate knowledge of or experience with the company, please forward this questionnaire to the appropriate person.

In Section IV, please mark the box under the letter corresponding to your rating, or mark “N/A” if you are unable to provide a rating for an area. Please provide narrative explanations for your answers. Space for your narrative remarks is provided after each area. If more space is required, attach additional sheets.

Exceptional Performance met contractual requirements and exceeded many requirements to the Government’s benefit. Contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good Performance met contractual requirements and exceeded some to the Government’s benefit. Contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance met contractual requirements. Contractual performance included some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal Performance did not meet some contractual requirements. Contractual performance contained serious problem(s) for which the contractor’s corrective actions appeared only marginally effective or were not fully implemented.

Unsatisfactory Performance did not meet most contractual requirements and recovery did not occur in a timely manner. Contractual performance contained serious problem(s) and corrective actions were ineffective.

N/A (Not Applicable)

Respondent has no personal knowledge.

Source Selection Information—See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

Section IV: PAST PERFORMANCE EVALUATION (To be completed by the Customer Agency)

Quality of Product - Conformance with requirements and overall quality N/A Comments:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Schedule - Ability to meet contractual delivery schedule N/A Comments:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Cost Control N/A Comments:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Business Relations - Resolution of problems with minimal disruption, responsiveness to customer requests

N/A Comments:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Small Business Involvement -Ability to meet small business goals N/A Comments:

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Source Selection Information—See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

SECTION V: GENERAL INFORMATION

1. Was a Show Cause letter or Cure Notice ever issued on this contract? ___Yes ___No.

If yes, please describe the circumstances and resolution if not already discussed above.

2. Would you recommend this contractor for similar Government contracts? _____Yes

_____No. If no, why not?

3. Have Contractor Performance Assessment Reporting System (CPARS) reports been submitted for this particular contract? _____Yes _____No