24Q0075_sol_0001_att1.docx

SOURCE SELECTION SENSITIVE INFORMATION PAST PERFORMANCE QUESTIONNAIRE

Name of Company Proposing:

Past Performance Reference Contract Information: ________________________________________________________

Name of Entity Providing Reference (Company/Agency/etc):

Contract Number:

Contract Title: Contract Value:

Reference POC: Phone Number:

Type of Contract: Period of Performance:

Description of Supply or Service:

The ratings below are supplied by the contractor reference identified above, NOT the offeror.

N/A - Not Applicable

5 - Exceptional- Performance meets contract requirements and significantly exceeds contract requirements to the Government’s/ industry’s benefit. For example, the contractor implemented innovative or business process reengineering techniques, which resulted in added value to the Government/Industry. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 - Very Good- Performance meets contractual requirements and exceeds some to the Government’s/ industry’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 - Satisfactory- Performance meets contractual requirements. The contractual performance of the element or sub- element contains some minor problems for which proposed corrective actions taken by the contractor appear satisfactory, or completed corrective actions were satisfactory.

2 - Marginal- Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has submitted minimal corrective actions, if any. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

1 - Unsatisfactory- Performance does not meet contractual requirements and recovery is not likely in a timely or cost effective manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Controlled By: Department of the Navy Controlled By: NSWC Crane Code 02 CUI Category: SSEL Distribution/Dissemination Control: FED ONLY POC: NSWC Crane 0243 Branch Head

Performance Elements

1. Quality of Product or Service

2. Timeliness of Performance

3. Effectiveness of Management

4. Initiative in Meeting Requirements

5. Response to Technical Direction

6. Responsiveness to Performance Problems

7. Compliance with Cost Estimates

8. Customer Satisfaction

9. Overall Performance N/A

Remarks on exceptional performance:

Provide data supporting this observation; you may continue on a separate sheet if needed.

Remarks on unsatisfactory or below performance:

Provide data supporting this observation; you may continue on a separate sheet if needed.

Please identify any corporate affiliations with the offeror.

Would you do business with this company again?

Information provided by:

Name: Title: Mailing Address: City, State and Zip Code: Telephone Number:

Please submit this Questionnaire no later than 2:00 p.m. EST January 29, 2023 via email to the NSWC Crane Division, Contracting Office POC at becky.a.minks.civ@us.navy.mil, telephone 812-381-7184

Source Selection Information - See FAR 2.101 and 3.1 Attachment (1)