Section J-03 Past Performance Questionnaire.docx
DOCX document 44 KB Posted
- Solicitation number
- 70Z02326R93280004
- Issued by
- Not on record
About this file
This is a Past Performance Questionnaire template for the Homeland Security Cutter - Light Icebreaker (HSC-L) solicitation issued by the United States Coast Guard under RFP No. 70Z02326R93280004. The questionnaire is designed to be completed by government agencies or companies that served as references for prospective offerors, evaluating contractor performance on relevant past contracts. Completed questionnaires must be submitted to William.E.Lewis3@uscg.mil by the proposal due date.
The questionnaire evaluates contractor performance across five key categories: Quality of Product or Service (conformance to specifications and workmanship standards), Schedule (timeliness of deliverables and milestones), Management (coordination, problem identification, subcontract management, and customer satisfaction), Regulatory Compliance (adherence to financial, environmental, safety, labor regulations, and reporting requirements), and an overall recommendation for similar future requirements. Evaluators assign ratings from five levels—Exceptional, Very Good, Satisfactory, Marginal, or Unsatisfactory—with detailed definitions provided for each category. The questionnaire requests comprehensive contract information including the contract number, award and completion dates, total dollar value, project title, and a detailed description of the contract effort including complexity, technical risk, key technologies, and production quantities. References must provide detailed justifications for assigned ratings and identify specific events or issues that support their assessments.
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Text version
Please provide your assessment of the prospective offeror’s level of past performance on a contract for which you were the reference. Please fill in the tables below and choose the appropriate rating from the drop-down list using the definitions on page two and provide justification for that rating. Prospective offeror or evaluator may fill out page one. Submitted questionnaire by the proposal due date to: William.E.Lewis3@uscg.mil.
| Contractor Being Evaluated |
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| Company/Government Agency Completing the Questionnaire |
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| Evaluator Name |
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| Period of Performance Being Assessed |
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| Contract Number |
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| Order Number (if applicable) |
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| Contract Award Date |
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| Contract Completion Date |
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| Total Dollar Value (includes unexercised options; ceiling amount for IDIQ) |
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| Current Dollar Value (current obligated amount) |
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| Project Title |
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| Contract Effort Description (Identify the key requirements and/or type of effort. The description should be detailed enough so that it can be used in determining the relevance of this program or project. Address the complexity of the contract/order effort and the overall technical risk associated with accomplishing the effort. Ensure acronyms are identified. Provide a complete description of the contract/order effort that identifies key technologies, components, subsystems, and requirements. Address annual production quantity. For task/delivery order contracts, state the number of orders issued during the |
period, the number of orders completed during the period, and the number of orders that remain active.)
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| Evaluator Email and Phone |
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Past Performance Questionnaire RFP No.: 70Z02326R93280004
| Rating |
| Definition |
| Justification |
| Exceptional |
| Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the |
contractor were highly effective.
To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.
| Very Good |
| Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for |
which corrective actions taken by the contractor was effective.
To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.
| Satisfactory |
| Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract/order. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be evaluated with a rating lower than Satisfactory |
solely for not performing beyond the requirements of the contract/order.
| Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated 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. |
| To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., |
management, quality, safety, or environmental deficiency report or letter).
| Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
| To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g., |
management, quality, safety, or environmental deficiency reports, or letters).
| Category and Description |
| Rating (drop down) |
| Justification |
Quality of Product or Service. Contractor’s conformance to contract/order requirements, specifications and standards of good workmanship.
| Choose an item. | Click or tap here to enter text. |
| Schedule. Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery |
schedules, and administrative requirements.
| Choose an item. | Click or tap here to enter text. |
| Management. Assess the integration and coordination of all activity needed to execute the contract/order, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, |
timely award and management of subcontracts.
| Choose an item. | Click or tap here to enter text. |
| Regulatory Compliance. Consider failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments. Assess compliance with all terms and conditions in the |
contract/order relating to applicable regulations and codes, Consider aspects of performance such as compliance with financial, environmental, safety, and labor regulations as well as any other reporting requirements in the contract terms and conditions.
| Choose an item. | Click or tap here to enter text. |
| Given what I know today I Choose an item. |
recommend them for similar requirements.
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