20110327 Attachment J Past Performance Questionnaire.doc

Attachment J

Past Performance Questionnaire Offeror - The Offeror shall complete Section1 and then send the entire questionnaire (Sections 1, 2, and 3) to at least three references in accordance with the instructions contained in Section L. A copy of Section 1 shall be included at the end of Offeror’s Volume 4 – Past Performance proposal.

References- The references shall then complete Section 2 Similarity of Work and Section 3 Degree of Customer Satisfaction. The questions are intended to be used to evaluate the history of performance of an Offeror submitting a proposal in response to the Conventional Weapons Destruction (CWD) Services RFP issued by the U.S. Department of State (DoS), Bureau of Political-Military Affairs, Office of Weapon Removal and Abatement. Completed Past Performance Questionnaires should be returned to Reginald E Smith and Deborah Koplen, Contacting Officer, U.S. Department of State, Office of Acquisition Management, on or before May 9, 2011at 2:00PM. Reply by e-mail is preferred (smithre4@state.gov and koplendj@state.gov) or by FAX to (703) 875-5895. References responses to this questionnaire will be considered confidential, except as explained below. Responses returned by Offerors will not be used in the Past Performance evaluation. For the purposes of this survey, "Offeror", refers to the specific Contractor that requested you to provide this information to the Government.

Section 1 – Information on Past Performance Reference (To be completed by Offeror and sent to Reference)

a. Name of person who will receive and respond to this Questionnaire

b. Title/Job Function

c. Agency/Company

d. Mail Stop/Suite

e. Address

f. City

g. State

h. Zip

i. Telephone Number

j. Fax

k. Date this Questionnaire forwarded to reference

Contract Information: The Offeror shall list the specific contract he would like the Reference to report on.

a. Contract name/Program name

b. Contract number

c. Type of contract

d. Name of contractor/subcontractor rated by this Performance Record Questionnaire. Include:

Address, Telephone and Name of POC

e. Date of contract award

f. Date contract completed

g. Specify whether the Offeror was the prime contractor or a subcontractor

h. If a subcontractor, specify the name of the prime contractor

a. Original Contract Amount

b. Estimate of Final Contract Amount

c. Amount Expended to Date

Section 2 – Similarity of Work (To be completed by References) Summary of Current Competitive Contract Requirements (DoS RFP): The Contractor shall provide Conventional Weapons Destruction (CWD) services worldwide in support of Department of State, Weapon Removal and Abatement Program, Bureau of Political and Military Affairs. CWD is defined as a set of programs that includes humanitarian mine action, battle area clearance, clearance of explosive remnants of war, small arms and light weapons destruction (to include at-risk munitions and MANPADS), stockpile and cache reduction and physical security and stockpile management. The effort requires the contractor to provide all personnel and equipment for worldwide CWD efforts and may include capacity building and advising and training of host country personnel. Total ceiling price is $250M.

Please provide a brief description of the Scope of Work this Contractor provided to you:

Rate the similarity of the type of effort required between the DoS RFP and the contract with which you are completing this questionnaire (i.e. DoS RFP is dissimilar, similar or are you unsure):

Rate the scope of effort required between the DoS RFP and the contract (i.e., the DoS RFP is smaller, similar or larger in scope):

Rate the complexity of effort required between the DoS RFP and contract (i.e., the DoS RFP is less complex, similar or more complex):

Section 3 – Degree of Customer Satisfaction (To be completed by References)

For each of the following areas, please check the box that indicates your experience with this contractor. If the question is Not Applicable, please check that box. Please include a narrative explanation whenever you feel that it is appropriate. If a rating of "Unsatisfactory" is given an explanation is required.

OFFEROR - Personnel, Management and Corporate Experience Rate the Offeror's performance with respect to:

1. Ability to Estimate and Contain Costs

Narrative:

2.

Quality and Adequacy of Personnel

3.

Quality and Adequacy of Resources

4.

Corporate Knowledge and Experience in Other Countries including Culture and Customs

5.

Ability to Coordinate and Cooperate with Host Nations and Others

6.

Ability to Coordinate and Competently Manage Teams, Subcontractors and Others

OVERALL RATING - Personnel, Management and Corporate Experience

OFFEROR – Operational Capability Rate the Offeror's performance with respect to:

7.

Knowledge and Expertise in providing Humanitarian Mine Action Services

8.

Knowledge and Expertise in providing Destruction Services

9 .

Knowledge and Experience in Physical Security and Stockpile Management

10.

Knowledge of Training and/or Advising Host Nations

11.

Processes and Procedures Reflect Industry and International Best Practices

12.

Ability to address Challenges such as changing environments, dealing with the unknown

OVERALL – Operational Capability

OFFEROR – Overarching Requirements Rate the Offeror's performance with respect to:

13.

Safety of Personnel and Equipment

14.

Security of Personnel and Equipment

15.

Adequacy of Medical Support

16.

Knowledge and Adequacy of Logistic

17.

Knowledge and Adequacy of Communications

18. Knowledge and Adequacy of Quality Assurance, Performance Metrics and Deliverables

OVERALL PERFORMANCE – Overarching Requirements

CUSTOMER SATISFACTION:

19.

If you were able to make the decision, would you select this Offeror again for a similar contract?

20.

Would you recommend this Offeror to others?

21.

Did the Contractor Exhibit Professionalism and Concern for Customer Needs and Requirements?

22.

Was the Contractor Committed to Outstanding Customer Service?

OVERALL PERFORMANCE – Customer Service

Provide any additional comments that you feel are important in the evaluation of the Offeror's performance: