Attachment_1_-_Past_Performance_Information_Sheet.docx

Attachment 1— Past Performance Information Sheet

Past Performance Information Sheet

Solicitation Number: N62645-16-R-0001, Medically Related Administrative & Programmatic Support Services for U.S. Naval Hospital Okinawa, Japan, U.S. Naval Hospital Yokosuka, Japan, and any associated branch clinics.

Closing Date: 2:00pm local time on 16 December 2015

The contractor shall complete Section I of the Past Performance Information Sheet and submit to the customer Point of Contact (POC) for completion of Section II. The customer POC shall submit the entire completed Past Performance Information Sheet (Sections I and II) directly to the Contracting Officer via email to usn.detrick.navmedlogcomftdmd.mbx.matrix@mail.mil no later than the closing date and time of the solicitation. The Government will not consider Past Performance Information Sheets submitted after the closing date and time of the solicitation.

Section I –Completed by Contractor Contract Number: Click here to enter text.

Contract Amount: Click here to enter text.

Description of Services: Click here to enter text.

If this is not the offeror’s contract describe how this past performance is pertinent. (See Section 2.2.3., 2.2.4., and 2.2.5. of Addendum to FAR 52.212-1 of the solicitation.) Click here to enter text.

Section II Completed by Customer - Submit entire completed Past Performance Information Sheet (Sections I and II) not later than the (2:00pm local time on 16 December 2015) via email to: usn.detrick.navmedlogcomftdmd.mbx.matrix@mail.mil

Please complete for all OCONUS medically related support services (administrative, programmatic, and/or clinical services) provided within the last 3 years for the contract(s) listed below.

Comments required in additional remarks for ALL marked NO

A. QUALITY OF SERVICE:

(1) The Contractor provided a service that conformed to contract requirements, specifications, and standards of good workmanship. Choose an item.

(2) The Contractor utilized personnel that were appropriate to the effort performed.Choose an item.

(3) The Contractor submitted accurate invoices and reports on a timely basis. Choose an item.

B. SCHEDULE AND COST CONTROL:

(1) The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract. Choose an item.

(2) The Contractor performed the effort within the estimated cost/price. Was the Contractor effective in forecasting/managing/controlling cost? Did they have cost growth or over runs? Choose an item.

C. BUSINESS RELATIONSHIPS:

(1) The Contractor demonstrated effective management over the effort performed. Choose an item.

(2) The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) were apprised of any issues. Choose an item.

(3) The Contractor presented information and correspondence in a clear, concise and businesslike manner. Choose an item.

(4) The Contractor cooperated with the Government in providing flexible, proactive, and effective solutions to critical issues. Choose an item.

D: OVERALL PERFORMANCE:

(1) How would you describe the overall performance by the Contractor? Choose an item.

(2) Would you consider working with the Contractor again in the future? Choose an item.

Why or why not? Click here to enter text.

ADDITIONAL REMARKS: (Comments required for ALL items marked NO)

Click here to enter text.

Individual completing the survey:

Name ____________________________ Title ___________________ Phone __________________________

____________________________________ Click here to enter a date.

Signature

Alternate Point of Contact:

Name ____________________________ Title ___________________ Phone __________________________