Attachment 04 - Past Performance Questionnaire.pdf
PDF 268 KB Posted
- Attached to
- MK 138 MOD 1 with Taggant, NSN: 1375-01-565-4810
- Solicitation number
- N0016424RJR95
About this file
This document is a Source Selection Sensitive Information Past Performance Questionnaire used to evaluate a contractor's performance history. The form contains a detailed rating scale from 1-5 (with N/A option) across nine performance elements including quality of product/service, timeliness, management effectiveness, initiative, technical responsiveness, problem-solving, cost compliance, and overall customer satisfaction. The questionnaire is designed to be completed by a reference contact who has direct experience with the contractor, with specific instructions that the ratings are to be supplied by the reference entity, not the offeror. The form provides space for detailed remarks on exceptional or unsatisfactory performance, corporate affiliations, and includes a final question about whether the reference would do business with the company again. The document is to be submitted via email to Eric Zipperle at the NSWC Crane Division Contracting Office, with contact information provided for follow-up.
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Text version
SOURCE SELECTION SENSITIVE INFORMATION
PAST PERFORMANCE QUESTIONNAIRE
Name of Company Proposing:
Past Performance Reference Contract Information
Name Of Entity Providing Reference: 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 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 / 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, 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
SOURCE SELECTION SENSITIVE INFORMATION
PAST PERFORMANCE QUESTIONNAIRE
Performance Elements N/A 5 4 3 2 1
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
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:
Fax Number:
Time of Call:
Da te Informa tion provided:
Please submit this Questionnaire via e-mail to the NSWC Crane Division, Contracting Office POC Eric Zipperle eric.r.zipperle.civ@us.navy.mil voice (812) 381-7230
File details come from the government source that posted it. Updated .