Attachment_III_-_Past_Performance_Report-Questionnaire.docx

PAST PERFORMANCE REPORT/QUESTIONNAIRE FORM

TO BE COMPLETED BY THE RESPONDENT AND RETURNED TO NAVSUP FLC NORFOLK.

PLEASE DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS REQUEST

A. The completion of this questionnaire is requested from your agency/company in order for the NAVSUP Fleet Logistics Center Norfolk to evaluate the aforementioned contractor’s past performance on previous contracts as it relates to the probability of successful accomplishment of the work required by the Government relative to the award of the contract resulting from the solicitation.

Please provide concise comments regarding your overall assessment of the contractor’s performance on the contract identified below. Please respond to each question in a narrative format. Please mail, fax, or e-mail your completed questionnaire directly to the address below:

Commanding Officer NAVSUP Fleet Logistics Center Norfolk Contracting Department, Attn: Monti Dutta, Code 230.2 1968 Gilbert Street Suite 600 Norfolk, VA 23511-3392 Phone: (757) 443-1330 Fax: (757) 443-1333 Email: monti.dutta@navy.mil

Company's Name ____________________________________ POC/Title/Position: __________________________________ Email Address: ______________________________________ Contract/Purchase Order No.__________________________ Contract Amount: ___________________________________ Contract Type: ______________________________________ Period of Performance: _______________________________ Business Address_____________________________________

Phone Number _____________________________________

1. Quality:

(i) Describe satisfaction with the Offeror

(ii) Describe instances of rework and/or deficiency reports

(iii) Describe effective and/or innovative work applications that were beneficial to you

2. Timeliness:

(i) Describe offerors demonstrated ability to comply with: delivery and/or performance schedules. What were the causes of any delay?

(ii) Describe timeliness of submission of requested information, reports, and invoicing

3. Responsiveness:

(i) Describe Offeror’s demonstrated ability to respond to your concerns.

(ii) Describe Offeror’s efforts to isolate and resolve problems and take systemic improvement action.

D. Identify the contractor's overall strengths and weaknesses.

E. Given the choice, would you award to this contractor again?

F. Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

G. Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.