Attachment_03-Past_Performance_Questionnaire.docx

Attachment 03

PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested by the Marine Corps Systems Command/CTQ to assist with establishing the performance history for the contractor named below. Please complete this questionnaire and mail, or scan and email it to the following:

Marine Corps Systems Command/Code CT2.5 Attn: Ms. Stefanie Conway 2200 Lester Street Quantico, VA 22134 Ph. 703-432-5776 E-mail: stefanie.conway@usmc.mil

When Complete, the information on this form is Source Selection Sensitive (41 USC Chapter 21); SAFEGUARD.

Requirement Description: The scope of this effort is to provide the United States Marine Corps with a Platoon Water Purification System (PWPS). The PWPS is a vehicle transported, man portable system capable of purifying fresh water, brackish water, and saltwater to supplement “liquid logistics” required by the Marine Infantry Platoon conducting distributed operations for up to 30 days operating in an austere environment while conducting distributed operations. The Contractor shall perform all tasks required to deliver the types and quantities of deliverables specified in the contract. This also includes providing technical and administrative support to a third party Contractor working for the Government that is responsible for the testing and/or development of the following: miscellaneous logistics documentation, technical manual development support; training package development; and parts information and characteristics data to support provisioning.

Contract Award Date:

Completion Date:

Contract Value:

Type of Contract:

Evaluator Name/Title/Phone:

Description of Contract Requirements:

|_| YES |_| NO A cure notice was issued under this contract.

|_| YES |_| NO A show cause was issued under this contract.

Evaluation: (Please provide comments to support your evaluation.)

A. Quality of Products, Documents, Presentations, and Related Deliverables |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

B. Effectiveness of Program Management, Quality Control, and Production Processes |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

C. Schedule Compliance for Services and Products |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

D. Quality of Engineering and Technical Products |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

E. Customer Satisfaction - Business/Management Relations.

|_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

|_| UNSATISFACTORY

F. Customer Satisfaction – Performance of Final Technical Products |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

G. Customer Satisfaction – Overall Performance |_| N/A Comments:

|_| OUTSTANDING

|_| EXCEEDS EXPECTATIONS

|_| MEETS EXPECTATIONS

H. Recommendation for Future Work |_| HIGHLY RECOMMENDED Comments:

|_| RECOMMENDED

|_| NEUTRAL

|_| RECOMMENDED WITH QUALIFICATIONS

|_| NOT RECOMMENDED

General Comments:

The information provided has been previously shared with the Contractor - |_| YES |_| NO

Please address questions regarding the use of this form to Ms. Stefanie Conway at stefanie.conway@usmc.mil .