Attachment L-3 Past Performance Questionnaire.docx

FOR OFFICIAL USE ONLY/ SOURCE SELECTION INFORMATION – SEE FAR 2.101, 3.104 AND 42.15

Section L, Attachment L-3

PAST PERFORMANCE QUESTIONNAIRES

Offeror Name: Role on this Solicitation: Contractor

Division Name:

CAGE Code: DUNS Number:

Contract Number: Task/Delivery Order: NAICS:

PSC: Contract Type:

Project Title:

Location of Work:

Agency/Customer Name and Location:

Agency/Customer Program Manager Name:

Title:

Email Address:

Phone Number:

Agency/Customer Contracting Point of Contact Name:

Title:

Email Address:

Phone Number:

Period of Performance START Period of Performance END

Base

Option 1

Option 2

Option 3

Option 4

Option 5

Total Contract Value: Contract Effort Description:

PERFORMANCE LEVELS

PERFORMANCE GRADES (Use these grades to provide the overall rating where requested below).

Exceptional - Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good - Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory - Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal - Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory - Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

QUESTIONS

TECHNICAL AND QUALITY PERFORMANCE

a. What kind of technical performance problems or strengths were experienced by the contractor?

b. What was the cause of these technical problems or strengths?

c. To what extent have corrective actions been taken to correct problem(s) identified above and to what extent have the corrective actions been effective? Describe the progress made to date. Also explain to what extent the corrective actions addressed the root cause of the problem(s) and led to systemic improvement such that similar problems would not reoccur.

d. Overall, the contractor's technical performance is rated ________________________.

|_|Exceptional |_|Very Good |_|Satisfactory |_|Marginal |_|Unsatisfactory

SCHEDULE PERFORMANCE

a. What kinds of delivery/schedule problems or strengths were experienced by the contractor?

b. What was the cause of these delivery/schedule problems or strengths?

c. To what extent have corrective actions been taken to correct problem(s) identified above and to what extent have the corrective actions been effective? Describe the progress made to date. Also explain to what extent the corrective actions addressed the root cause of the problem(s) and led to systemic improvement such that similar problems would not reoccur.

d. Overall, the contractor's delivery/schedule performance is rated _________________.

COST PERFORMANCE

a. What kinds of Cost problems or strengths were experienced by the contractor?

b. If the contractor experienced an overrun please provide the percentage. _________

c. What was the cause of these Cost problems or strengths?

d. If available, provide earned value cost performance measures including indices for cost efficiency (CPI) and schedule efficiency (SPI). Based on this information, please provide a narrative assessment of their performance.

e. To what extent have corrective actions been taken to correct problem(s) identified above and to what extent have the corrective actions been effective? Describe the progress made to date. Also explain to what extent the corrective actions addressed the root cause of the problem(s) and led to systemic improvement such that similar problems would not reoccur.

f. Overall, the contractor's Cost performance is rated ________________________.

MANAGEMENT

MANAGEMENT RESPONSIVENSS

What was the contractor’s record of timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals (especially responses to change orders, engineering change proposals, or other undefinitized contract actions), the contractor's history of reasonable and cooperative behavior, effective business relations, and customer satisfaction?

SUBCONTRACT MANAGEMENT

What was the contractor’s success with timely award and management of subcontracts, including whether the contractor met or exceeded small business, small disadvantaged business, small business HUBZone, veteran-owned small business, service disabled veteran owned small business, women-owned small business participation and subcontracting goals?

PROGRAM MANAGEMENT AND OTHER MANAGEMENT

a. To what extent does the contractor discharge their responsibility for integration and coordination of all activity needed to execute the contract; identify and apply resources required to meet schedule requirements; assign responsibilities for tasks/actions required by contract; and communicate appropriate information to affected program elements in a timely manner?

b. What were the contractor’s risk management practices, especially the ability to identify risks and formulate and implement risk mitigation plans?

c. If applicable, identify and provide information on any other areas that are unique to the contract, or that cannot be captured elsewhere under the Management Assessment.

Overall Management Assessment

Overall, the contractor's management performance is rated____________________.

Small Business Utilization

If this contract contains a small business subcontracting goal, assess compliance with all terms and conditions in the contract relating to Small Business participation (including FAR 52.219-8, Utilization of Small Businesses and FAR 52.219-9, Small Business Subcontracting Plan (when required). Assess any small business participation goals which are stated separately in the contract Assess achievement on each individual goal stated within the contract or subcontracting plan including good faith effort if the goal was not achieved. Check one of the boxes below, noting however when applying the rating definitions for this assessment equate “small business goals” to requirements.

OTHER Is there any other information regarding this acquisition that you think would be helpful to our evaluation? If so please explain. Examples of additional information that could be helpful to our evaluation include information on (1) problems or strengths with regard to key personnel and (2) the kind of business relationship problems or strengths with regard to management of subcontracts, cooperation with business partners/customers, customer satisfaction, etc.

SUMMARY: If you had the option, knowing what you know today, would you (pick one), 1) definitely would not, 2) probably would not, 3) might, 4) might not, 5) probably would, 6) definitely would award this contract to this contractor, given the choice? Please explain.

Signature _____________________________________________ Date _____________ Please note that electronic signatures are acceptable. An e-mail from the originator of this document will suffice. Signatures (electronic or hand written) verify that the signatory completed this form and agrees with the information contained within it.