Past Performance Questionnaire OMSAS IV fillable.pdf

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OFFENSIVE MISSILE SYSTEM ANALYSIS SUPPORT Amendment 02
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HHM402-21-R-0016
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PAST PERFORMANCE QUESTIONNAIRE

FOR

OFFENSIVE MISSILE SYSTEM ANALYSIS AND SUPPORT IV

Please complete the questionnaire and email, fax or mail to the addressee as follows:

Noryem Maldonado Email: Noryem.maldonado@dodiis.mil Fax: (256) 313-7979 Phone Number: (256) 313-7391

Address: Defense Intelligence Agency/ Missile and Space Intelligence Center Virginia Contracting Activity Attn:CFO4B5/MSIC/Noryem Maldonado Building 4545, Fowler Rd Redstone Arsenal, AL 35898-5500

SUBMITTED BY:

(Agency)

COMPANY BEING RATED:

Name:

Address:

POC:

INSTRUCTIONS:

Type of contract (Check all that apply)

[ ] Negotiated [ ] Sealed Bidding [ ] [ ] Non-Competitive [ ] Firm-Fixed-Price [ ] Cost-Plus-Fixed-Fee [ ] Time-and-Material [ ] Labor Hour [ ] Other _____ _

Complete the following:

Competitive [ ] Requirements [ ] Indefinite Quantity

Period of Performance: ___ / __ / ____ to--~/ ____ / Initial Contract Value: $ _______ _ Current (or Completed) Contract Value: $ ________ _

Brief Description of Requirement:

Complexity of Effort: [ ] Difficult [ ] Routine

Source Selection Information - See FAR 2.101 and 3 .104

For each item, annotate (bold, circle, or check) the rating that best describes the contractor's work on the contract, or if you do not know how the contractor performed ( or is performing on a particular item), please annotate (Not Applicable (N/ A) on that item. The rating scale is defined below.

0 Not Applicable (N/ A): Does not apply or you do not know.

1 Unsatisfactory Achievement of contract requirement is compromised

2 Poor Requires major agency resources to ensure achievement of contract requirements

3 Fair Requires minor agency resources to ensure achievement of contract requirements.

4 Good Does not impact achievement of contract requirements

5 Excellent No problems, issues, or delays in achieving contract requirements

6 Outstanding Cases where contractor performance exceeds Excellent

*Note: Sufficient detail shall be provided in the Comment block for ratings other than Good ( 4) or NI A (0) supporting the selected rating.

CONTRACT INFORMATION

1. QUALITY OF SERVICE:

a Overall abili Ratin 0 5 Comment:

(b) Effectiveness reliabilitv of contractor's kev oersonnel.

Rating 0 I 1 I 2 I 3 I 4 I 5 I Comment:

( c) Abilitv to recruit and maintain qualified oersonnel.

Rating 0 I 1 I 2 I 3 I 4 I 5 I Comment:

to satisfy security re uirements ( clearances for ersonnel, information rotection, facilities, etc. .

0 1 2 3 4 5 6

Comment:

e Abili to effectivel im lement "start-u erformance.

Ratin O 1 3 4 5 6 Comment:

Source Selection Information- See FAR 2.101 and 3.104

2. TIMELINESS OF PERFORMANCE

(a) Overall performance in planning, scheduling, and monitoring the work effort.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

(b) Completion of maior milestones on schedule:

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

c Res onsiveness and flexibili Ratin O 1 2 3 4 5 6 Comment:

Ratin 0 5 6 Comment:

(e) Timely completion of Efforts within period of performance.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

3. PRICE/COST CONTROL:

a) Qualit , com leteness, and accurac of rice/cost ro osals.

Ra tin O 1 2 3 4 5 6 Comment:

(b) Accuracy and timeliness of cost reports.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

(c) Abili to Ratin 3 4 5 6 Comment:

(d) Accuracy and completeness of vouchers/invoices.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

( e) Incurrence of costs is in accordance with contract terms.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

4. BUSINESS RELATIONS:

(a) Abilitv to effectively manage contract.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

to choose subcontracts if a licable to this contract bein re orted on .

0 1 2 3 4 5 6

Comment:

if a licable to this contract bein re orted on).

2 3 4 5 6

Comment:

(d) Provides prompt notification of problems.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

( e) Or anizational su rovides ade uate s an of control and su ervision.

Ratin 0 2 3 4 5 6 Comment:

(f) Has the contractor been given cure notice(s), show cause notices(s), suspension of progress payments, or letters of direction, etc.?

Ratin Yes No Comment:

Source Selection Information- See FAR 2.101 and 3.104

5. MANAGEMENT of KEY PERSONNEL:

oint of contact to mana e and resolve roblems.

2 3 4 5 6

Comment:

b Effectively assesses im acts of otential chan es on other associated ro·ects, tasks, and efforts.

Ra tin O 1 2 3 4 5 6 Comment:

(c) Effectiveness in interfacing with Government personnel.

Rating 0 I I I 2 I 3 I 4 I 5 I 6 Comment:

d) Abili to solve contract roblems without extensive idance from Government ersonnel.

Ratin 0 2 3 4 5 6 Comment:

Government re uirements and is res onsive to the Government's needs.

2 3 4 5 6

Comment:

(f) Rate the contractor's overall technical performance on this contract.

Rating 0 I 1 I 2 I 3 I 4 I 5 I 6 Comment:

6. Based on this contractor's overall performance, would you award this contractor another Government contract?

YES

I

NO

I Ifno, please explain:

7. Please provide any additional comments concerning the past performance of the contractor.

Comment:

8. This questionnaire was completed by:

(Print Name)

(Organization)

(Commercial/DSN Telephone Numbers)

(Date of Completion)

Labor Hour Other:
Period of Performance:
undefined:
undefined_2:
to:
undefined_3:
Initial Contract Value:
Current or Completed Contract Value:
Brief Description of Requirement:
Comment:
Co:
0 1 2 3 4 5 6Comment:
1 2 3 4 5 6Comment:
Comment_2:
0 1 2 3 4 5 6Comment_2:
0 1 2 3 4 5 6Comment_3:
5 6:
Comment_3:
0 1 2 3 4 5 6Comment_4:
undefined_6:
4 5 6Comment:
0 1 2 3 4 5 6Comment_5:
3 4 5 6Comment:
0 1 2 3 4 5 6Comment_6:
Co_2:
0 1 2 3 4 5 6Comment_7:
0 1 2 3 4 5 6Comment_8:
0 1 2 3 4 5 6Comment_9:
Comment_4:
Comment_5:
undefined_7:
0 I 2 3 4 5 6Comment:
0 1 2 3 4 5 6Comment_10:
0 I 2 3 4 5 6Comment_2:
0 I 2 3 4 5 6Comment_3:
Comment_6:
0 I 2 3 4 5 6Comment_4:
YES NOIfno please explain:
Comment_7:
Print Name:
Organization:
CommercialDSN Telephone Numbers:
Date of Completion:
Check Box2: Off
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Check Box10: Off
Check Box11: Off
Check Box12: Off
Text13:
Check Box14: Off
Check Box15: Off
Group1: Choice1
Text16:
Text17:
Text18:
Text19:
Text20:

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