PAST PERFORMANCE DATA.doc

PAST PERFORMANCE DATA

(Note: Offerors are not to change the spatial structure of this form, i.e. borders, block size, etc.)

1. Complete Name of Reference (Government agency, commercial firm, or other organization)

2. Complete Address of Reference

3. Contract Number or other control number

4. Date of contract

5. Date work was begun

6. Date work was completed

7. Contract type, initial contract price, estimated cost and fee, or target cost and profit or fee

8. Final amount invoiced or amount invoiced to date

9a. Reference/Technical point of contact (name, title, address, telephone no. and email address)

9b. Reference/Contracting point of contact (name, title, address, telephone no. and email address)

10. Location of work (country, state or province, county, city)

11. Current status of contract (choose one):

[ ] Ongoing

[ ] Complete

[ ] Terminated for Convenience

[ ] Terminated for Default

[ ] Other (explain)

12. Provide brief information describing the contract and the relevancy of the effort to be performed in accordance with the SOW and requirements of the solicitation. Provide an estimated % of relevancy of the referenced contract to the requirements set forth in this solicitation. Relevance shall address the following areas: Ship Time Charter & Ship Operation services. Relevance can be discussed in further detail on the attached summary description as set forth in block 14 below.

13a. Did this contract require a Small Business Subcontracting Plan pursuant to FAR 52.219-9? Yes ____, No_____.

13b. If “Yes” to 13a, have you regularly submitted SF 294/295 reports on time?

13c. Attach a copy of your most recently submitted SF 294.

14. Provide a summary description of contract work, not to exceed two pages in length. Describe the nature and scope of work, its relevancy to this contract, and a description of any problems encountered and your corrective actions. Attach the explanation to this form.

PAST PERFORMANCE EVALUATION

NAME:

FACSIMILE:

PHONE:

EMAIL:

INFORMATION REQUEST

PAST PERFORMANCE

The Military Sealift Command (MSC) is currently in the process of soliciting offers for a contract for subject matter experts for an operational assessment. . provided your name and organization as a reference regarding past performance under . Specifically, we are looking for past performance information in the following areas:

a.) Quality of Service b.) Timeliness or Scheduling of Service c.) Business Relations/Customer Satisfaction d.) Key Personnel and Staffing (Including Subcontractors)

In order for our team to compile its evaluation, we request that you complete the attached survey form and email it, with any other pertinent information, to Jeff Fugate at jeffrey.fugate@navy.mil.

Information can also be sent via facsimile to the attention of Jeff Fugate at (202) 685-5084.. Your assistance in accurately accessing the performance of the aforementioned Contractor is greatly appreciated.

Thank you, Jeff Fugate

Contracting Specialist

For your convenience, a cover sheet for use in mailing/faxing is provided below.

Military Sealift Command

(202) 685-5084 (fax) Attn: Jeff Fugate/N10 Military Sealift Command Headquarters

914 Charles Morris Court, SE

Washington Navy Yard DC 20398-5540

From:

CONTRACTOR PERFORMANCE EVALUATION SURVEY

1.

Please describe the service/supply provided by the Contractor for your firm.

2. Please provide ratings and comments regarding the Contractor’s performance in each area below using the following ratings: Satisfactory (S), Unsatisfactory (U) or Neutral (N). See below for definition of ratings. For all ratings please provide a brief explanation on a separate sheet.

OVERALL PAST PERFORMANCE RATING

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

a.) Quality of Service:

Conformance to contract requirements, appropriateness of personnel, accuracy of reports, and technical excellence.

b.) Timeliness or Scheduling of Service/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 d.) Key Personnel and Staffing (Including Subcontractors)

Quality of key personnel and how well key personnel managed their portion of the contract.

3.

Would you hire this contractor to provide services for your organization in the future?

Y FORMCHECKBOX

N FORMCHECKBOX

. Please provide comments using additional pages if desired.

Signed:__________________________________

PAST PERFORMANCE DEFINITIONS

The following definitions should be used when assessing past performance:

SATISFACTORY – The contractor’s performance under this contract has satisfied all requirements and expectations, without necessarily exceeding them.

UNSATISFACTORY – The contractor’s performance under this contract has failed to satisfy all requirements and expectations.

NEUTRAL – No performance under this contract is relevant to this rating area.

PROCUREMENT SENSITIVE