M95494-17-R-0031_Attachment_A_-_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE TEMPLATE

Instructions:

· Sections II and III to be completed by the Offeror/Major Subcontractor and provided to the assessor (Government personnel who had experience with the Offeror/Major Subcontractor on a previous relevant contract). The assessor, in turn, to verify Sections II and III, complete the questionnaire, and submit to the Contracting Office. The Offeror should also submit with its proposal (by the closing date of the Solicitation) copies of Sections I and II of all questionnaires as provided to assessors.

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

· Sections III and IV 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) to: Erika Chavarria at erika.chavarria@usmc.mil.

I. Solicitation Data (for the proposed effort)

II. Current or Historical Contract Information

Assessor: The performance data submitted by the Offeror is |_| correct or |_| incorrect.

CONTRACTOR NAME

& ADDRESS:

Contract Number

Type of Contract

Contract Value

Period of Performance/ Delivery Schedule

Requirement Description

Please select from the following as it applies to this contract:

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.

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. Performance Evaluation

Please provide ratings and comments regarding the Contractor’s performance in each area below using the following ratings: Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Applicable (N/A). See next page for definition of ratings. For ratings of “Exceptional” or “Unsatisfactory,” please provide a brief explanation.

OVERALL PERFORMANCE RATING

Please provide an overall rating of the Contractor’s performance for the referenced contract/delivery order.

a.) Quality of Product or Service: Conformance to contract requirements, appropriateness of personnel, accuracy of reports, and technical excellence b.) Timeliness or Scheduling of Supplies/Deliveries: Timeliness of performance, met interim milestones, reliable, responsive to technical and contractual direction as to scheduling.

c.) Business Relations/Customer Satisfaction: Effective management, prompt notification of problems, reasonable/cooperative behavior, proactive, timely award and management of subcontracts, effective small business/small disadvantaged business subcontracting program and satisfaction with Contractor’s service.

d.) Key Personnel and Staffing (Including Subcontractors): Qualified personnel, effective performance and conduct.

e) Cost Control (**COST CONTRACTS ONLY**): Actual cost / rates reflect closely to negotiated cost / rates, adequate budgetary internal controls, current, accurate and complete billings

Would you hire this Contractor to provide supplies/services for your organization in the future? Yes |_| No |_| Please provide comments using additional pages if desired

Evaluation Definitions

The following definitions should be used in your assessment of Contractor performance.

FOR OFFICIAL USE ONLY