PP Questionnaire.docx
DOCX document 53 KB Posted
- Attached to
- Floating Docks for Fast Response Cutter Federal contract opportunity
- Solicitation number
- 70Z02320QOCOM01
About this file
This document contains a past performance questionnaire for a solicitation seeking floating docks for fast response cutters. The Coast Guard is requesting assistance evaluating a contractor's past performance on a previous contract by completing a questionnaire addressing quality, schedule, technical requirements, cost control, and customer satisfaction. Respondents are asked to indicate their evaluation of the contractor's performance in these areas using a rating scale of exceptional, very good, satisfactory, marginal, and unsatisfactory. Additional remarks can be provided for any areas rated unsatisfactory. The questionnaire requests contract details including number, initiation and completion dates, value, and type. Evaluators are asked to provide their name, position, organization, months of performance monitoring, and any existing past performance ratings in CPARS or other systems.
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Text version
70Z023023OCOM01
Section L, Attachment 1
PAST PERFORMANCE
QUESTIONNAIRE
Your assistance is requested in support of a source selection.
Please complete this Questionnaire and return to:
Mailing Address:
COMMANDANT (CG-9127)
ATTN Rebecca Deale, Contracting Officer
US COAST GUARD
2100 2ND ST SW STOP 7112
WASHINGTON DC 20593-7112
FAX: 202-340-4146
EMAIL: Rebecca.deale@uscg.mil
When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION IAW (41 U.S.C. 423) and shall be protected accordingly
TO BE COMPLETED BY OFFEROR
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor Name and Address:
B. Contract No:
C. Contract Initiation Date:
D. Completion Date: ____________________________________________
E. Contract Value:
F. Type of Contract:
G. Description of Contract Requirements:
TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE
SECTION 2: EVALUATOR IDENTIFICATION
A. Evaluator’s name: ___________________________
B. Evaluator’s Position: ____________________________
C. Evaluator’s Organization: ____________________________
D. Evaluator’s phone number:____________________________
E. Months Performance Monitored By Evaluator: ____________
SECTION 3: EVALUATION
Please indicate your response for each topic that best reflects your experience with this contractor by placing an “X” in the appropriate block using the scale as defined below:
| RATING |
| DEFINITION |
| EXCEPTIONAL (E) |
| Performance met all contract requirements and exceeded many to the Government’s benefit. Problems, if any, were negligible and were solved in a timely, highly effective manner. |
| VERY GOOD (V) |
| Performance met all contract requirements and exceeded some to Government’s benefit. There were a few minor problems that the contractor resolved in a timely, effective manner. |
| SATISFACTORY (S) |
| Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory. |
| MARGINAL (M) |
| Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective. |
| UNSATISFACTORY (U) |
| Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. |
| UNKOWN (UN) |
| No record of past performance or the record is inconclusive. |
NOTE: If you have rated this contractor on this particular contract or project in CPARS or some other evaluation system accessible to the Government, you may indicate that past performance information on this contract/project is available in the appropriate system and you may include a copy of that rating in lieu of the following questionnaire.
Please discuss every instance for which you indicated U (Unacceptable) in response to the questions below (use additional sheets, if necessary).
| QUALITY OF PRODUCTS AND SERVICES – Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health) |
| E |
| V |
| S |
| M |
| U |
| UN |
Remarks:
| PERFORMANCE – Assess the contractor’s performance as the General Contractor or Architect/Engineer (as appropriate) for the project. |
| E |
| V |
| S |
| M |
| U |
| UN |
| SCHEDULE– Assess the timeliness of contractor against schedule of activities. |
| E |
| V |
| S |
| M |
| U |
| UN |
| TECHNICAL REQUIREMENTS – Assess the contractor’s ability to fulfill the technical requirements of the contract. |
| E |
| V |
| S |
| M |
| U |
| UN |
| COST CONTROL – Assess the contractor’s ability to manage the contract budget and control costs. |
| E |
| V |
| S |
| M |
| U |
| UN |
| CUSTOMER SATISFACTION– Assess the contractor’s responsiveness to customer concerns. |
| E |
| V |
| S |
| M |
| U |
| UN |
OVERALL ASSESSMENT
| E |
| V |
| S |
| M |
| U |
| UN |
If an Award Fee contract, what was the average Award Fee % earned?
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