Attachment_S-5_-_Past_Performance_Questionnaire_ARCO.docx

N55236-18-R-0011: ARCO (ARDM-5) DSCO

PAST PERFORMANCE QUESTIONNAIRE

Instructions to Offeror

Completed questionnaires shall be forwarded directly to the Southwest Regional Maintenance Center point of contact listed in this letter.

NOTE: ONCE COMPLETED BY THE POC, QUESTIONNAIRES MUST BE DIRECTLY TRANSMITTED TO THE GOVERNMENT AS DESCRIBED ON THE FOLLOWING PAGE. COMPLETED QUESTIONNAIRES RECEIVED FROM OFFERORS ARE NOT ACCEPTABLE.

Instructions to Evaluator

The Southwest Regional Maintenance Center is requesting an evaluation of an offeror’s past performance for source selection purposes. Accordingly, we request your candid assessment of the offeror’s past performance; please see Section A below for the identity of the offeror and contract of interest.

Once completed, this questionnaire and any appended information becomes Source Selection Sensitive and must be protected from disclosure. Access to this information shall be limited to Government procurement officials.

Please forward the completed questionnaire no later than 18 January 2019 to Ms. Allison Alexander at allison.e.alexander@navy.mil and Mr. Paul Von Franzke at paul.von_franzke@navy.mil.

Hand-written evaluations are acceptable. Please answer each question in SECTION B by circling one of the ratings: E V S M U N/A, where:

EExceptional; VVery Good; S-Satisfactory;

MMarginal; UUnsatisfactory; N/ANot Applicable

Exceptional - Contractor performance substantially exceeded expected levels of performance.

Very Good - Contractor performance exceeded expected levels.

Satisfactory – Performance met expected levels.

Marginal - Performance was less than expected.

Unsatisfactory - Performance was significantly less than expected.

In addition, please provide supporting comments for each rating. Please use your supporting comments to highlight the Offeror’s specific strengths and weaknesses. You may use additional sheets if required. Your ratings and comments should reflect only “contractor liable” performance. You may supplement your knowledge with the knowledge and judgment of others in your organization.

Please enter the requested information in SECTION C for the person primarily responsible for completing the questionnaire before transmitting the completed questionnaire to the points of contact identified above. Thank you for your assistance in this matter.

PLEASE DO NOT PROVIDE COMPLETED QUESTIONNAIRES TO THE OFFEROR

SECTION A (To Be Completed by the Offeror)

1. Name of Offeror/Contractor: __________________________________________________

Address of Offeror/Contractor: ________________________________________________

2A. Contract Number (between Prime and Sub):_______________________________________

Task or Order No., where applicable: ___________________________________________

2B. Contract Number (between Government and Prime):________________________________

Task or Order No., where applicable: ___________________________________________

3A. Period of Performance: ______________________________________________________

3B. Place of Performance: _______________________________________________________

4. Description of Work/Scope of Effort (max. 50 words): _____________________________

6. Method and Date Questionnaire Sent to POC:

SECTION B (To Be Completed by Evaluator)

E Exceptional; V-Very Good; S-Satisfactory;

M Marginal; U Unsatisfactory; N/A Not Applicable

1. Overall Contract Outcome: E V S M U N/A Ability to satisfactorily complete all tasks while conforming to customer requirements, standards of good workmanship and safe practices.

Comments: _____________________________________________________________________

2. Cost Performance: E V S M U N/A Ability to accurately forecast and control costs throughout all phases of the contract.

Comments: _____________________________________________________________________

3. Schedule Performance: E V S M U N/A Ability to develop accurate work schedules and adhere to those schedules, as well as the ability to adapt to changes in requirements and work schedules.

Comments: _____________________________________________________________________

4. Technical Performance (Quality of Product): E V S M U N/A Ability to overcome technical challenges by applying sound engineering principles, complete required engineering analyses and develop adequate technical reports and plans.

Comments: _____________________________________________________________________

5. Subcontracting Plan Adherence and Coordination: E V S M U N/A If a subcontracting plan was required please describe the offerors success in meeting planned goals and/or efforts made to overcome goal deficiencies and challenges as well as the offeror’s ability to successfully manage and integrate subcontractors.

Comments: _____________________________________________________________________

SECTION C (To Be Completed by Evaluator)

1. Name of Evaluator: _____________________________________________________________

2. Position Title: _________________________________________________________

3. Administrating Authority/Agency: _________________________________________________

5. Signature: ______________________________Date: ____________

Please transmit completed questionnaire to allison.e.alexander@navy.mil and paul.von_franzke@navy.mil SOURCE SELECTION INFORMATION Attachment S-5

SEE FAR 2.101 AND 3.104

N55236-18-R-0011