N3904021Q0080 Attachment 3_Past Performance_Reference_Form.pdf

N3904021Q0098 Attachment 3

PAST PERFORMANCE REPORT FORM

Solicitation N3904021Q0098

To be completed by Offeror’s References/Customers and returned directly to the Contracting Office:

Complete and return NLT ______03/22/2021_________to:

Portsmouth Naval Shipyard Contracting Department Attn: Danelle Quinn, Code 410.1 Email: danelle.quinn@navy.mil

On behalf of (Requester Information):

Company's Name: _________________________________ POC/Title/Position: _________________________________ Email Address: _________________________________ Contract/Purchase Order No.: _________________________________ Contract Amount: _________________________________ Contract Type: _________________________________ Period of Performance: _________________________________ Business Address: _________________________________

Phone Number: _________________________________

NOTE: PLEASE DO NOT RETURN TO THE CONTRACTOR WHO

ORIGINATED THIS REQUEST

The completion of this questionnaire is requested from your agency/company in order for the use of Portsmouth Naval Shipyard to evaluate the aforementioned 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.

Report completed by:

Command/Company’s Name: _________________________________ POC/Title/Position: _________________________________ Email Address: _________________________________ Address: _________________________________

Phone Number: _________________________________

*Please provide an assessment that reflects how well the contract requirements were met, level of satisfaction with performance, and relating to confidence in their abilities.

*Please mark “Not Applicable” if the performance in an area not applicable to effort being assessed.

1. Quality/Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract.

a. How would you describe your level of customer satisfaction?

b. Were there instances of rework and/or deficiency reports? (If yes, explain)

c. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?

2. Quality/Timeliness.

a. Describe the contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?

b. Describe the timeliness of submission of requested information, reports and invoicing.

3. Quality/Contractor Responsiveness.

a. Describe the offeror’s demonstrated ability to respond to customer concerns

b. Describe the offeror’s demonstrated ability to isolate and resolve problems the number and severity of problems the effectiveness of corrective actions taken.

c. Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/under-run, Government-imposed schedule changes, etc.)

4. Additional Observations/Information

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

b. Given hindsight, are you satisfied that the contract was awarded to this contractor?

Would you be pleased to have this contractor perform work for you again? Why?

c. 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.

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

(If more comment space needed, please write below or attach additional pages.)