Past Performance Questionnaire Template.JAN2021.pdf

N0016721Q0063

Attachment 2

Recent and Relevant Past Performance Questionnaire

1. Past Performance Assessment. The Naval Surface Warfare Center, Carderock Division (NSWCCD) is soliciting competitive offers for emergency COVID-19 cleaning services.

The Infrastructure Division has identified a need for a BPA contract in order to complete deep cleaning of areas known or suspected of having COVID-19 exposures at the NSWC- Carderock site and detachment sites nationwide.

2. It is requested that you complete and submit this questionnaire via e-mail to the following individuals no later than the closing date and time specified on page 1 of the combined synopsis/solicitation: N0016721Q0063

Naval Surface Warfare Center, Carderock Division (NSWCCD)

Attn: Michelle Siebeking-Knox (Code 0223) 904 Corporate Ln.

Chesapeake, VA 23320

Telephone: 757-410-0512 E-mail: michelle.r.knox@navy.mil

Naval Surface Warfare Center, Carderock Division (NSWCCD)

Attn: George DelMoral (Code 0223) 904 Corporate Ln.

Chesapeake, VA 23320 Telephone: 757-513-7194

E-mail: george.delmoral@navy.mil

RETURN THE COMPLETED QUESTIONNAIRE TO THE ABOVE CONTRACTING

POINTS OF CONTACT.

*NOTE: IT IS THE RESPONSIBILITY OF THE OFFEROR TO ENSURE ALL PAST

PERFORMANCE QUESTIONNAIRES ARE SUBMITTED TO THE GOVERNMENT

BY THE PROPOSAL SUBMISSION CLOSING DATE AND TIME.

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 or the Contract Specialist at the above e-mail addresses.

mailto:Glen.savory@navy.mil mailto:Vanessa.rincon@navy.mil

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

2. Contract Information. Please complete the following:

Contractor:

Contract Number:

Period of Performance:

Dollar Amount at Award:

Dollar Amount at Completion

(or Current Dollar Amount, if not Completed):

Contract Type: Fixed-Price;

Labor Hour or Time and

Material; Cost-

Reimbursement (CPFF, CPAF, CPIF, etc.)

Describe the Products or

Services:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

3. Contract Relevancy. For comparison with the size and scope of Solicitation

N0016721Q0063, please provide the following information pertaining to the contract identified in Section 2 above:

(a) Size: $______ per year in contract services.

(b) Scope: Check all that apply:

_____ Program Management Support

_____ Planning Support

_____ Business and Financial Management Support

_____ Acquisition and Contract Management Support

_____ Technical Management Support

_____ General Logistics Management Support

_____ Engineering Support

_____ Other Support (please describe: ________________________)

4. Performance Assessment Values.

5 – Outstanding. Performance meets contractual requirements and exceeds many requirements, to the Government’s benefit. Contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4 – Excellent. Performance meets contractual requirements and exceeds some requirements, to the Government’s benefit. Contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3 – Good. Performance meets contractual requirements. Contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

2 – Satisfactory. Performance barely meets some contractual requirements. Contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor's proposed actions appear only marginally effective or were not fully implemented.

1 – Unsatisfactory. Performance does not meet some or most contractual requirements and recovery is not likely in a timely manner. Contractual performance of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

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

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

5. Assessment Elements. Please select/circle the appropriate performance assessment value for each item on the questionnaire and provide supporting narrative.

a. Cost Control. 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 on the scale provided below.

5 4 3 2 1 0

Provide reasons for changes to the contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes).

Comments:

b. Schedule. Rate the contractor’s ability to deliver according to the agreed-to schedule on the scale provided below.

5 4 3 2 1 0

What were the causes of any schedule variances?

Comments:

c. Mission Requirements. Rate the contractor’s ability to provide a product or service that met your mission requirements on the scale provided below.

5 4 3 2 1 0

Comments:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

d. Quality. Rate the contractor’s ability to provide a product or service that met your required level of quality, on the scale provided below.

5 4 3 2 1 0

Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards.)

Comments:

e. Security Requirement. Rate the contractor’s ability to comply with security requirements including the management of Classified information, if applicable, on the scale provided below.

5 4 3 2 1 0

Comments:

f. Subcontract Management. Rate the contractor’s ability to award and manage subcontracts, if applicable, on the scale provided below.

5 4 3 2 1 0

Comments:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

g. Business Relations. 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 on the scale provided below.

5 4 3 2 1 0

Comments:

h. Management of Key Personnel. Assess the contractor’s performance in selecting, retaining, supporting, and replacing—when necessary—key personnel.

5 4 3 2 1 0

Comments:

i. 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:

6. Other References. If you are aware of any other Point of Contact (POC) who is familiar with the contractor’s performance under this contract, please identify below.

Name, Phone, and E-mail

Address:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

7. Assessor Information. Please provide the following information about yourself and a brief summary of your responsibility in relation to performance under this contract:

Name:

Title:

Address:

Phone Number:

E-mail Address:

Role and Responsibility:

Thank you for your assistance.