Attachment_J-2_-_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

I. Past Performance Assessment. The Naval Sea Systems Command (NAVSEA), Washington Navy Yard, is soliciting competitive offers for the Dismantlement and Disposal of the Surface Ship Support Barge (SSSB).

It is requested that you complete this questionnaire and provide via e-mail to the individual named below no later than the Closing Date/Time specified in Block 9 on the cover of the solicitation.

Naval Sea Systems Command Attn: Forrest Tucker, Contracting Officer (0242) 1333 Isaac Hull Avenue SE STOP 2030 Washington Navy Yard, DC 20376-2030 forrest.tucker@navy.mil

*NOTE: IT IS THE RESPONSIBILITY OF THE OFFEROR TO ENSURE ALL PAST PERFORMANCE QUESTIONNAIRES ARE SUBMITTED TO THE GOVERNMENT BY THE SOLICITATION CLOSING DATE AND TIME IF DATE IS DIFFERENT THAN ABOVE.

If you need more space than that provided, please attach additional pages. Responses will be treated as source selection sensitive information. If you have any questions, please contact the Contracting Officer at the above e-mail address.

II. Contract Information:

Contractor:

Contract / Task Order Number:

Respondent:

Period of Performance:

Phone:

Contract Type:

Position:

Amount of Contract:

E-Mail Address:

Place of Performance:

End Item or Service Performed:

III. Performance Assessment Values

5 - Excellent: Superior performance. Always, with inconsequential exceptions.

4 - Good: Outstanding performance. Most of the time, with only rare exceptions and the exceptions had minor consequences.

3 - Adequate: Generally satisfactory performance. Most of the time, but with occasional exceptions. In most cases, exceptions had minor consequences.

2 - Marginal: Occasional unsatisfactory performance. Frequently not, with significant consequences in some cases.

1 - Poor: Generally unsatisfactory performance. Almost never, with significant consequences in many cases.

0 - Not applicable: Unable to provide a score. Performance in this area not applicable to effort assessed.

IV. Assessment Elements

Instructions for Customers/Past Performance References: For each of the following questions, Please select/circle the appropriate performance assessment value for each item on the questionnaire and provide supporting narrative.

1. Technical

a. Rate the extent to which the Contractor’s product conformed to the specifications of this contract

5 4 3 2 1 0

b. If there were any particularly significant risks involved in the performance of this contract, please rate the Contractor’s ability to manage those risks.

5 4 3 2 1 0

Comments:

2. Schedule

a. Rate the Contractor’s adherence to the agreed-to schedule. What were the causes of any schedule variances?

5 4 3 2 1 0

Comments:

3. Cost Control

a. Rate the contractor’s effectiveness in forecasting, managing, and controlling cost (including reporting and analyzing variances) and ability to deliver at the agreed-to cost/price. Provide reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes).

5 4 3 2 1 0

Comments:

4. Subcontracting

a. Rate the contractor’s ability to meet any applicable subcontracting goals for utilization of Small Business (SB), Small Disadvantaged Businesses (SDB), Women-Owned Small Businesses (WOSB), Service-Disabled Veteran-Owned Small Business (SDVOSB), HUBZone and Historically Black Colleges and Universities/Minority Institutions (HBCU/MI).

5 4 3 2 1 0

b. Rate the contractor’s ability to meet the goals of the subcontracting plan, to include the ability to timely award and manage subcontracts.

5 4 3 2 1 0

Comments:

5. Business Relations

a. Rate the contractor’s ability to integrate and coordinate all activities needed to execute the contract, specifically the timeliness, completeness, quality of problem resolution, corrective action plans, the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and its ability to submit accurate invoices in a timely manner.

5 4 3 2 1 0

Comments:

6. Recommendation. To what extent would you recommend this contractor for additional contracts? Rate on the following scale: 5 = Yes, definitely; 4 = Yes, likely; 3 = Maybe, 2 = No, not likely; 1 = No, not ever; 0 = N/A.

5 4 3 2 1 0

Comments:

7. Assessor Information. Please provide the following information about yourself:

Name

Title

Address

Phone Number

E-Mail Address