EXHIBIT_12_-_Past_Performance_Questionnaire.pdf

EXHIBIT 12

PAST PERFORMANCE QUESTIONAIRE

RFP NNG16547352R

Exhibit 12

NNG16547352R

This form contains Source Selection Information when completed. See FAR 3.104.

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

(Updated September, 2010)

Sections I through III provide for contract-related descriptive information and identification of the evaluator.

Section IV lists the major work elements within our Statement of Work (SOW). Please provide your assessment of the “relevant experience” and “performance” associated with our SOW evidenced within the contract for which you are a reference. Your assessment of the relevancy should reflect the fact that the principal purpose of our contract is for the performance of Independent Verification and Validation (IV&V) of selected software systems being developed by or for NASA and other Federal, State and local government agencies. Independent Verification and Validation (IV&V) is a systems engineering process employing rigorous methodologies for evaluating the correctness and quality of the software system throughout the development life cycle (http://www.nasa.gov/centers/ivv/home/index.html).

“Significant Experience” means that a full range of services was routinely performed by the contractor under the associated SOW element. “Moderate Experience” describes a contractor who has experience in several aspects of a work element even though the experience may not have been on a continuous basis or directly related to the purpose of our contract. “Minimal Experience/Did not Perform” means that, although at least some aspects of the work may have been performed, such performance was limited in scope or frequency, or the work element was not performed under the contract.

Section V evaluates the contractor’s technical, schedule, and cost performance and management. (Additional pages may be used for comments if desired). It is very important to keep in mind that only performance in the past 5 years is relevant. If you cannot answer any questions, please circle “N/R” for Not Rated.

The following definitions are offered for your use in assigning a performance rating for each of the factors in Sections IV and V:

Very High

(VH)

The Offeror’s relevant past performance is of exceptional merit;

indicating exemplary performance in a timely, efficient, and economical manner; very minor (if any) problems with no adverse effect on overall performance.

High

(H)

The Offeror’s relevant past performance demonstrates very effective performance that would be fully responsive to contract requirements with contract requirements accomplished in a timely, efficient, and economical manner for the most part with only minor problems with little identifiable effect on overall performance.

Moderate

(M)

The Offeror’s relevant past performance t demonstrates effective performance; fully responsive to contract requirements; reportable problems, but with little identifiable effect on overall performance.

Low

(L)

The Offeror’s relevant past performance meets or slightly exceeds minimum acceptable standards; adequate results; reportable problems with identifiable, but not substantial, effects on overall performance.

Very Low

(VL)

The Offeror’s relevant past performance does not meet minimum acceptable standards in one or more areas; remedial action required in one or more areas; problems in one or more areas which, adversely affect overall performance.

N/R Not Rated

Section VI provides for evaluation of the contractor’s management of cost and award/incentive fee history.

http://www.nasa.gov/centers/ivv/home/index.html

RETURN THIS QUESTIONNAIRE TO NASA Goddard Space Flight Center BY TBD. Attn: Danit Rainey, Code 210.P Greenbelt, MD 20771 Phone: 301-286-1496 e-mail: Danit.Rainey@nasa.gov mailto:Danit.Rainey@nasa.gov

PAST PERFORMANCE QUESTIONNAIRE

I. Contract Information

A. Name of Company/Division Being Evaluated: _____________________

B. Address: _____________________________________________

C. Contractor Cage Code and/or DUNS number: ____________________

D. Contract Number: _______________________________________

E. Contract Type: _________________________________________

F. Period of Performance (including options): From: ______ To: _______

G. Total Contract Value: _____________________________________

H. Award Information: Competitive: Yes___ No___ Basis of Selection: Technical___ Cost/Price___ Other (specify) _________________________

II. Description of Contract

Briefly describe the services provided under this contract:

During the contract performance being evaluated, this firm was the:

Prime Contractor____ Significant Subcontractor ____ Team Member ____ Other (describe) ____________________________________________

Does a corporate or business relationship exist between the firm being evaluated and your organization?

Yes ___ No ___. If yes, please describe: ___________________________

III. Evaluator Information

Name: _____________________________________________________ Title: ______________________________________________________ Agency/Company: ___________________________________________ Address: ___________________________________________________ Phone: ____________________________________________________ Role in Program/Contract: _____________________________________ Length of Involvement in this Program/ Contract: ___________________

IV. SOW Survey: Relevant Experience and Performance Ratings: Please check the appropriate blocks for both Relevance (Significant, Moderate, Minimal/Did Not Perform) and the Performance (VH, H, M, L, VL, N/R) for each SOW Element Listed below (see page 1 definitions and instructions). Comments can be provided in Section VI).

SOW ELEMENT

SIGNIFICANT

MODERATE

MINIMAL/

DID NOT

PERFORM

PERFORMANCE RATING

(Please circle)

Systems Safety Engineering Services VH H M L VL N/R

Industrial Hygiene and Radiation Protection VH H M L VL N/R

Occupational Safety VH H M L VL N/R

Lifting Devices and Equipment (LDE)/Pressure Vessels and System (PVS) –(Recertification)

VH H M L VL N/R

Reliability and Risk Assessment Engineering VH H M L VL N/R

Mission Software and Ground Systems Assurance VH H M L VL N/R

Quality Engineering VH H M L VL N/R

Metrology and Calibration/Repair Service of Measurement and Test Equipment

VH H M L VL N/R

Systems Reviews VH H M L VL N/R

Management Systems VH H M L VL N/R

V. General Performance Survey (comments can be provided in Section VI).

NO PERFORMANCE QUESTIONS

PERFORMANCE RATING

(Please Circle)

1 Overall effectiveness of program management and contract oversight VH H M L VL N/R

2 Resource planning and flexible staffing solutions (part-time, off-site, emergency tasks, etc...) VH H M L VL N/R

3 Technical Leadership and Internal Communications VH H M L VL N/R

4 Content, accuracy, quality, and timeliness of technical reports and deliverables VH H M L VL N/R

5 Ability to meet performance requirements within costs and schedule VH H M L VL N/R

6 Effective Issue Tracking and Risk Management VH H M L VL N/R

7 Contractor’s ability to identify and correct performance deficiencies in a timely manner VH H M L VL N/R

8 Adherence to procedural requirements and quality management systems. VH H M L VL N/R

9 Overall Safety and Health injury/illness record VH H M L VL N/R

10 Ability to effectively manage subcontractor performance VH H M L VL N/R

Ability to build effective working relationships with associate contractors, subcontractors and the Government in a team environment.

VH H M L VL N/R

12 Adequacy of systems and processes for task order management VH H M L VL N/R

13 Overall Communication and responsiveness to Government requests VH H M L VL N/R

14 Ability to establish realistic estimates (cost and schedule) VH H M L VL N/R

15 Timeliness, quality, and accuracy of reporting (cost and schedule) VH H M L VL N/R

16 Ability to anticipate and manage change (scope, schedule, cost, and personnel) VH H M L VL N/R

17 Ability to recruit highly skilled personnel, and fill key vacancies in a timely manner. VH H M L VL N/R

18 Skill Mix and Distribution of Technical Expertise VH H M L VL N/R

19 Personnel Management (Training, Incentivizing, and Retaining) VH H M L VL N/R

Section VI:

What is the Contract Value:

Initial Value Current Value Estimated Cost: $___________ $____________

Fee: $___________ $____________

Total Value: $___________ $_____________

Briefly describe any change(s) from original contract value:

What are the total contract expenditures to date (cost/fees to date based on invoices, reports, etc)?

What is the Annual Contract Value to Date (The current contract expenditures to date divided by the number of years of performance to date)?

Was there a cost overrun or underrun? ( ) Yes ( ) No If yes, please provide period of performance, and explain (include actions contractors taken to control/address the situation. Did the Contractor take proactive steps/measures/actions to rectify the cost overruns/underruns?):

If this was an award fee contract, what are the individual and/or overall average ratings of performance by your organization throughout the period of performance? Please attach any available award fee letters or database entries.

Please comment on particularly strong/weak points of Contractor’s performance (technical, schedule, and/or cost).

Overall Contract Performance Rating (circle one)

Very High High Moderate Low Very Low

Would you select this Contractor Again? ( ) Yes ( ) No

Please add any other comments you may feel are pertinent.

Rater’s Signature

Date Questionnaire Completed