EXHIBIT_13_-_Past_Performance_Questionnaire.pdf

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 The principal purpose of our contract is to furnish comprehensive support services to the Goddard Institute for Space Studies (GISS) in the following areas: scientific programming and analysis; systems programming and analysis including systems programming, data handling and data teleprocessing; computer facility operations including computer security; library services and publication services; logistical support; and project management support.

“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 3 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:

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.

N/R Not Rated

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

RETURN THIS QUESTIONNAIRE TO NASA Goddard Space Flight Center BY TBD. Attn: Tiffanie Ferrell, Code 210.5 Greenbelt, MD 20771 Phone: 301-614-5323 FAX: 301-286-5373 E-mail: Tiffanie.c.ferrell@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: ______________ Date Questionnaire Completed: _______________ 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 (H, M, L, N/R) for each SOW Element Listed below (see page 1 definitions and instructions).

SOW ELEMENT

SIGNIFICANT

MODERATE

MINIMAL/

DID NOT

PERFORM

PERFORMANCE RATING

(Please circle)

H M L N/R

Scientific Programming and Analysis H M L N/R

H M L N/R

Global Climate Modeling H M L N/R

H M L N/R

Earth Observations H M L N/R

H M L N/R

Climate Impacts H M L N/R

H M L N/R

Planetary Atmospheres H M L N/R

H M L N/R

Computer Facility Operations H M L N/R

H M L N/R

Logistical, Physical Safety, and Utility Support H M L N/R

H M L N/R

Program Management H M L N/R

H M L N/R

Library and Publication Services H M L N/R

H M L N/R

H M L N/R

H M L N/R

H M L N/R

H M L N/R

H M L N/R

H M L N/R

V. General Performance Survey

NO PERFORMANCE QUESTIONS

PERFORMANCE RATING

(Please Circle)

1.

Overall performance in planning and controlling the program

H M L N/R

2. Quality of services and support provided H M L N/R

3.

Compliance with technical requirements and performance standards

H M L N/R

4.

Content, accuracy, quality, and timeliness of technical reports and deliverables

H M L N/R

5.

Ability to design and/or deliver a product that meets or exceeds performance requirements within costs and schedule

H M L N/R

6. Timely identification and mitigation of risks H M L N/R

7.

Contractor’s ability to identify and correct performance deficiencies in a timely manner

H M L N/R

8.

Ability to recruit and retain highly skilled personnel, including ability to fill key vacancies in a timely manner.

H M L N/R

9. Ability to handle fluctuating workloads H M L N/R

10. Adherence to safety and health procedures H M L N/R

11. Overall Safety and Health injury/illness record H M L N/R

12.

Demonstrated understanding and compliance with mission safety requirements

H M L N/R

13. Communicating and interfacing with Government H* M L N/R

14.

Ability to effectively manage subcontractor performance

H M L N/R

15.

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

H M L N/R

16.

Timeliness, quality, and accuracy of schedule reporting

H M L N/R

17.

Adequacy of Contractor’s system(s) for processing task orders and/or changes.

H M L N/R

18. Overall responsiveness to Government requests H M L N/R

19. Ability to establish realistic cost estimates H M L N/R

20. Ability to establish realistic schedule estimates H M L N/R

21.

If performance based, how successful was the Contractor in meeting the contract metrics?

H M L N/R

22.

Adherence to estimated costs and contract cost targets

H M L N/R

23.

Ability to anticipate, identify and control cost growth.

H M L N/R

24.

Timeliness, quality, and accuracy of Small Business Subcontracting Plan reporting

H M L N/R

25.

Timeliness, quality, and accuracy of financial reporting

26. Overall evaluation of cost performance H M L 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? ( ) Yes ( ) No If yes, please explain:

If this was an award fee contract, what are the individual and/or average ratings of performance by your organization? 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)

High Moderate Low

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

Please add any other comments you may feel are pertinent.

Rater’s Signature Date