SAQMMA16R0280-_Attachment_4-_FINAL_Past_Performance_Questionnaire.pdf

SAQMMA16R0280 – ATTACHMENT 4

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND FAR 3.104

WHEN COMPLETED, FOR OFFICIAL USE ONLY

ATTACHMENT 4

PAST PERFORMANCE QUESTIONNAIRE

Offeror Instructions: Complete Transmittal Letter and Section 1 of the Past Performance Questionnaire (PPQ) and send to the assessor(s). Ensure assessor returns a copy of the completed questionnaire to the Department of State POC identified below prior to the solicitation closing date and time.

Assessor Instructions: Confirm accuracy and completeness of Section 1 of the PPQ. Complete Section 2 of the PPQ and submit Sections 1 and 2 directly to the Contracting Officer. Do not forward a copy of the completed questionnaire to the vendor whose performance you are evaluating. To be considered, the information must be received by the Government prior to the solicitation closing date and time.

INSERT DATE

TO: Assessor Name Agency / Organization Name Address

FROM: Company Name Address

SUBJECT: Past Performance Questionnaire for (PROGRAM TITLE/DESCRIPTION) concerning contract number(s) (CONTRACT AND ORDER NUMBER (IF APPLICABLE) TO BE EVALUATED). The effort was performed by (SPECIFIC ENTITY THAT PERFORMED THE WORK) under (CAGE code/DUNS#).

1. We are currently responding to the US Department of State Request for Proposal (RFP) SAQMMA16R0280 for INL UNMISS South Sudan Support. The Government is placing increased emphasis on past performance in order to obtain best value in source selections. The RFP specifically requires that we, as an Offeror, send the attached questionnaire to several points of contact (POCs) on recent and relevant efforts that we (or a proposed team member) have performed.

2. We have identified subject contract(s) as relevant to this acquisition and you as our POC. As such, please take a few moments of your time to fill out the attached questionnaire and forward it directly to the US Department of State. DO NOT RETURN THE COMPLETED QUESTIONNAIRE TO US. The information contained in the completed Present/Past Performance Questionnaire is considered Source Selection Information (See FAR 2.101 and FAR 3.104) and may not be released to us.

3. The completed Past Performance Questionnaire (Sections 1 and 2) should be sent directly to the US Department of State not later than (DATE TO BE INSERTED BY OFFEROR, PRIOR TO PROPOSAL DUE DATE AND TIME). The questionnaires must be emailed to MavroukakisA@state.gov.

4. If you have any questions regarding the questionnaire, you may contact Alexander Mavroukakis of the US Department of State at (703) 475-4801 or via email at MavroukakisA@state.gov. Thank you for your timely assistance.

Sincerely, (TITLE AND NAME OF COMPANY OFFICIAL)

Attachment: Past Performance Questionnaire mailto:MavroukakisA@state.gov

PAST PERFORMANCE QUESTIONNAIRE

SECTION 1 – TO BE COMPLETED BY OFFEROR

This Past Performance Questionnaire is submitted in response to RFP SAQMMA16R0280 (INL UNMISS South Sudan Support) as part of <insert name of entity submitting proposal> proposal.

1. Company Information: Include name, address, and cage code of company (prime or major subcontractor) for which this reference is provided.

2. Program Title:

3. Contract Number (including Delivery / Task Order number if applicable):

4. Contract Award Basis: Competitive Non-Competitive

5. Contract Date:

6. Role: Prime Contractor Subcontractor Other: (Specify)

If other than a prime contractor, provide the prime contractor’s name, address, and cage code:

7. Name and Address of Contracting Activity / Customer:

8. Primary Points of Contact: Offeror is responsible for exerting its best efforts to ensure that current information is provided for all individuals. If this is a commercial reference Offeror should change the Title, if appropriate, to commercial equivalents.

Title Name Phone E-Mail

1. PCO

2. ACO

3. COR / CORT

4. Other (Please Specify)

9. Contract Type(s): List all that apply (e.g. FFP, FPIF, CPFF, CPIF, LH, and T&M).

10. Contract Value:

a. Awarded Total Contract Value:

(Including all options)

b. Current Total Contract Value:

(Including all options)

c. Explanation for difference between awarded and current contract values:

11. Period of Performance:

a. Current (including all exercised options): MM/DD/YEAR to MM/DD/YEAR

b. Potential (including all options): MM/DD/YEAR to MM/DD/YEAR

12. Place of Performance: List all that apply. If multiple locations, please indicate annual dollar value and full time equivalents (FTEs) per location.

13. Scope of work

a. Describe work performed by your company:

b. Relevancy: Provide information that demonstrates why this reference is relevant. Explain what aspects of performance under this reference are deemed relevant to the proposed effort and to what aspects of the proposed solicitation they relate to.

14. What were the key positive attributes about your performance?

15. What were the less than positive attributes and how were these resolved? The offeror is required to clearly demonstrate management actions employed in overcoming problems and the effects of those actions in terms of improvements achieved or problems rectified. Comment on any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions.

16. Has this contract been partially or completely terminated for default or convenience?

Yes No

If yes, please provide additional details:

17. Are there any pending terminations?

If yes, please provide additional details:

SECTION 2 – TO BE COMPLETED BY ASSESSOR

Your feedback is requested by the US Department of State, Office of Acquisition Management.

In efforts to expedite receipt of the requested information, the Contracting Officer respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire (Sections 1 and 2) to MavroukakisA@state.gov. Please contact Alexander Mavroukakis at MavroukakisA@state.gov should you have any questions.

DO NOT RETURN THE COMPLETED QUESTIONNAIRE TO THE OFFEROR. The information contained in the completed Past Performance Questionnaire is considered Source Selection Information (See FAR 2.101 AND FAR 3.104) and may not be released to the Offeror.

EVALUATED BY:

I, the undersigned, being familiar with the work and the performing organization I’m providing information about, have responded to the best of my knowledge and belief. I understand that a representative of the Department of State may contact me for confirmation of my responses to this PPQ. I am authorized by my organization to complete this evaluation.

Name and Title: _____________________________ Organization: _____________________________

Signature: _____________________________ Date: _____________________________

1. Is the information completed by the Offeror in Section 1 of this questionnaire accurate, current, and complete?

If no, please explain / correct:

2. Performance Evaluation

Assign a rating to each area based on the ratings guidelines below. Please provide a narrative explanation for any rating of marginal or less.

EXCEPTIONAL (E)

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

VERY GOOD (VG)

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

SATISFACTORY (S) Performance meets contractual requirements. The contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL (M)

Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

UNSATISFACTORY (U)

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

NOT APPLICABLE

(N/A)

Unable to provide a rating. Contract did not include performance for this aspect. Do not know.

a. Scope of Work:

E VG S M U N/A

1. Performance conformed to contract requirements, of similar scope in a war or conflict zone.

2. Liaised with multiple International Organizations simultaneously in the areas of Law Enforcement or Corrections.

b. Quality of Services:

1. Contractor provided personnel with the appropriate security clearances, qualifications, and experience required to perform the contract.

2. Performance conformed to contract requirements, specifications, and standards of good workmanship (e.g.

commonly accepted technical, professional standards).

3. Contractor provided accurate and complete reports and other documentation.

4. Contractor was proactive in identifying, notifying the Government, and resolving performance issues/concerns.

c. Compliance with Schedule:

1. Contractor performed services in a timely manner.

2. Contractor provided contract reports and deliverables on time.

d. Cost Control:

1. Contractor completed performance within the established cost parameters.

2. Contractor invoices were current, accurate, and complete.

3. Contractor actions that resulted in cost savings to the Government without a sacrificing quality of services or schedule.

e. Business Relations:

1. Contractor has a history of reasonable and cooperative behavior and effective business relations.

2. Contractor is dedicated to customer satisfaction.

3. Contractor has a history of submitting viable and timely proposals for required contract modifications or task orders.

4. Contractor effectively adapt to changes in mission requirements and priorities.

f. Management

1. Contractor effectively managed multiple task orders simultaneously covering multiple disciplines and locations.

2. Contractor effectively selected, retained, supported, and replaced (when necessary) personnel with the experience and expertise necessary to accomplish the Government’s requirement.

3. Contractor adequately managed and controlled government furnished property and facilities.

4. Contractor effectively managed all subcontractors.

3. Identify the contractor’s overall strengths and weaknesses:

4. Would you have concerns working with this firm again?

If yes, please explain:

5. Additional information not included above: