16-T-0060_-_Attachment_5_-_Past_Performance_Report_Form_-_5.pdf

N39040-16-T-0060 Attachment 5

PAST PERFORMANCE REPORT FORM

Solicitation N39040-16-T-0060

Complete and return NLT ____10/14/2016____to:

Emily Bateman, Contract Specialist, Code 410.2 Portsmouth Naval Shipyard, Kittery, ME 03904 Phone: (207) 438-6819 Fax: (207) 438-4193 Email: emily.bateman@navy.mil

PLEASE DO NOT RETURN TO THE OFFEROR WHO ORIGINATED THIS REQUEST

The completion of this questionnaire is requested from your agency/company in order to evaluate the contractor’s past performance on previous contracts and efforts, as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract.

Completed by:

Company’s Name: ______________________________________ POC/Title/Position: ______________________________________ Email Address: ______________________________________ Address: ______________________________________ Phone Number: ______________________________________

On behalf of (Requester Information):

Company's Name: ______________________________________ POC/Title/Position: ______________________________________ Contract Number/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 Offeror’s 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.

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

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

6. 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.

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