ATTCH 5 Past Perf Questionnaire.doc

PAST PERFORMANCE QUESTIONAIRE

SP0600-07-R-0300

SOURCE SELECTION INFORMATION IAW FAR 3.104

ATTACHMENT 5

Provide the information requested in this form for each contract/program being described. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations set forth at paragraphs e, of Section L of this solicitation.

A.

Offeror Name (Company/Division):

CAGE Code:

DUNS Number:

(NOTE: If the company or division performing this effort is different than the offeror or the relevance of this effort to the instant acquisition is impacted by any company/corporate organizational change, note those changes. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume.)

B.

Program Title:

C.

Contract Specifics:

1. Contracting Agency or Customer _____________________________________________

2. Contract Number

3. Contract Type

4. Period of Performance

5. Original Contract $ Value _________________ (Do not include unexercised options)

6. Current Contract $ Value _________________ (Do not include unexercised options)

7. If Amounts for 5 and 6 above are different, provide a brief description of the reason ________________________________________________________________________________________________________________________________________________________________ D.

Brief Description of Effort as __Prime or __Subcontractor

(Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition)

E.

Completion Date:

1. Original date:

2. Current Schedule:

3. Estimate at Completion:

4. How Many Times Changed:

5. Primary Causes of Change:

F.

Primary Customer Points of Contact: (For Government contracts, provide current information on all three individuals. For commercial contracts, provide points of contact fulfilling these same roles.)

1. Program Manager:

Name

Office

Address

Telephone

2. Contracting Officer:

Name

3. Administrative Name

Contracting Officer

G.

Address any technical (or other) area about this contract/program considered unique.

H.

For each of the applicable sub-factors under the Technical Capability and Management and Mission Capability factor in Section M, illustrate how your experience on this program applies to that sub-factors. If commodity is different, please explain why/how they relate to this procurement.

I.

Specify, by name, any key individual(s) who participated in this program and are proposed to support the instant acquisition. Also, indicate their contractual roles for both acquisitions.

(If FAR 52.219-8, Utilization of Small Business Concerns, is included in Section I of the solicitation, insert the paragraph below to comply with the past performance evaluation requirement of DFARS 215.305(a)(2).)

J.

Include relevant information concerning your compliance with FAR 52.219-8, Utilization of Small Business Concerns, on the contract you are submitting.

(If FAR 52.219-9, Small Business Subcontracting Plan, is included in Section I of the solicitation, insert the paragraph below to comply with the past performance evaluation requirement of DFARS 215.305(a)(2).)

K.

Identify whether a subcontracting plan was required by the contract you are submitting. If one was required, identify, in percentage terms, the planned versus achieved goals during contract performance. If goals were not met, please explain.

L.

Describe the nature or portion of the work on the proposed effort to be performed by the business entity being reported here. Also, estimate the percentage of the total proposed effort to be performed by this entity and whether this entity will be performing as the prime, subcontractor, or a corporate division related to the prime (define relationship).

M. Identify technical expertise in the form of manpower, equipment, similar production processes or facilities that the contractor has access to which would apply to the requirements of the contract solicitation. (This is especially important if requesting the Past Performance volume early, as the PRAG will not have any other source for this information, which is critical to their relevancy determination)

ATTACHMENT 3: PAST PERFORMANCE QUESTIONNAIRE

(This questionnaire is intended as a sample. Tailor the questionnaire to solicit the information your PRAG will need to make their Performance Confidence Assessment. This questionnaire should be accompanied by a transmittal letter explaining its purpose.)

SOLICITATION NUMBER(CO enter before sending.)____________________

1. Please complete this questionnaire. Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information. Fax the completed questionnaire to:

DESC-MK, ATTN: Sylvia Urias-Vallejo, Contracting Officer

2261 Hughes Ave, Suite 128

Lackland Air Force Base, TX. 78236-9828

DSN phone: 9445-2127

Commercial phone: 210-925-2127

DSN fax: 945-9758

Commercial fax: 210-925-9758

2. Explanation of codes:

CODE

PERFORMANCE LEVEL

E EXCEPTIONAL - Performance meets contractual requirements and exceeds many (requirements) 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 were highly effective.

V VERY GOOD - Performance meets contractual requirements and exceeds some (requirements) 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 were effective.

S SATISFACTORY - 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.

M MARGINAL - 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 or the contractor's proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY - 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 serious problem(s) for which the contractor's corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score. Performance in this area not applicable to effort assessed.

3. Please complete the following identifying information and past performance assessment:

A. Contractor:

B. Contract number:

C. Period of Performance:

D. Negotiated price or cost at award:

E. Current estimated contract dollar amount:

F. Describe product acquired:

4. Circle the appropriate letter for each item on the questionnaire and provide supporting narrative.

(The following assesment elements and questions are very general and intended only as a sample. Your PRAG should write the elements and questions to solicit the information they believe they'll need to make their Performance Confidence Assessment.

ASSESSMENT ELEMENTS

(1) Contractor's cost control. Did the contractor deliver at the agreed-to price/cost? Describe the reasons for changes to contract value (e.g., scope changes, overrun/underrun, Government-imposed schedule changes, etc.)

E

V

S

M

U

N

(2) Did the contractor deliver according to the agreed-to schedule? What were the causes of any schedule variances?

S

M

U

N

(3) Did the product or service meet the mission requirement?

E

V

S

M

U

N

(4) Did the product or service meet the required level of quality?

S

M

U

N

(5) Did the contractor meet applicable goals for utilization of small, small disadvantaged, woman-owned small business concerns, historically black colleges and universities and minority institutions?

E

V

S

M

U

N

(6) What is your overall rating of the contractor’s performance?

E

V

S

M

U

N

(7) Did the contractor maintain a stable workforce in key management and technical areas?

E

V

S

M

U

N

(8) How did this contractor react to customer driven requirements and changing delivery schedules?

E

V

S

M

U

N

(9) Does the contractor have a history of proposing new and innovative processes to meet the customer’s product and delivery requirements?

E

V

S

M

U

N

(10) Is the contractor proactive in proposals which produce multiple and cost effective resolutions to recurring production, logistical, and/or delivery problems?

E

V

S

M

U

N

(11) Did the contractor demonstrate the ability to maintain a well trained workforce?

E

V

S

M

U

N

(12) What are some examples which demonstrate the contractor’s commitment to safety and quality?

(13) Identify the contractor's overall strengths and weaknesses.

(14) Given the choice, would you award to this contractor again?

(15) Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

(16) Is there anyone else we should send this questionnaire to? Please identify by name, organization, and phone number.

(If more comment space needed, write on back, or attach pages.)

5. Please provide the name, title, address, and phone number of the person completing this questionnaire.

Phone FAX____________________

6. Thank you for your assistance in this source selection. If you have any questions, please call Sylvia Urias-Vallejo, Contracting Officer, (Contracting Officer) at 210-925-2127.