Attachment 2 - Solicitation Past Performance Questionaire.pdf

DEFENSE LOGISTICS AGENCY

HEADQUARTERS

8725 JOHN J. KINGMAN ROAD

FORT BELVOIR, VIRGINIA 22060-6221

April 25, 2012

Dear Sir or Madam:

Defense Logistics Agency (DLA) Energy Bulk Petroleum Business Unit is acquiring services to fulfill its mission. Our current solicitation, is procuring services for operation and maintenance of aviation and ground fuel bulk storage on an Air Force (AF) installation. The selected contractor will operate existing bulk fuel storage facilities in support of normal base operations, deployments, exercises, contingencies and during periods of heightened security. Fuel operations at the bulk fuel facility must be safely and efficiently conducted in order to receive, store, transfer, issue, and account for petroleum products with the appropriate controls required to maintain inventory accuracy and ensure fuel quality.

DLA is conducting a past performance survey in anticipation of a contract award. An offeror who has submitted a proposal for this work has identified you as a Point of Contact (POC) on a past or present contract which the offeror deems relevant to our current need. We are, therefore, requesting your assistance in completing the attached Past Performance Questionnaire so that we may evaluate the offeror in the area of past performance.

It would be greatly appreciated if you could provide your comments regarding the overall assessment of the offeror’s performance on the contract identified. It would also be very helpful if you could provide any additional information which your organization would deem relevant to our evaluation team. It is important that your information be as factual, accurate and complete as possible in order to prevent the need for follow-up by the evaluators.

Please complete and submit the Questionnaire within 3 days of receipt and return via email to Contract Specialist, Jessica Negron @ jessica.negron@dla.mil or by mail to DLA Energy Bulk Petroleum 8725 John J.

Kingman Rd Suite 2945, Fort Belvoir, VA 22060-6222 Attn: Jessica Negron. If you have any questions relative to the enclosed Questionnaire, please call her at (703) 767-9342.

Thank you in advance for your assistance.

Sincerely, PATRICIA A. LITTLEJOHN

Contracting Officer Bulk Petroleum Business Unit mailto:jessica.negron@dla.mil

ATTACHMENT 2

SP0600-12-R-0507

- 2 -

SOURCE SELECTION INFORMATION - SEE FAR 2.101 AND 3.104

PAST PERFORMANCE QUESTIONNAIRE

Note: The past performance experience questionnaire consists of a total of seven (7) pages

CONTRACT INFORMATION (Offeror to complete blocks 1-4)

1. Contractor Information:

CONTRACTOR NAME: CCR CAGE CODE:

ADDRESS: CCR DUNs NUMBER:

PHONE NUMBER:

EMAIL ADDRESS:

POINT OF CONTACT: CONTACT PHONE NUMBER:

2. Work Performed as: ______ Prime Contractor ______ Sub Contractor ______ Join Venture ______ Other (Explain)

If subcontractor, who was the prime (Name/Phone#):

3. Contract Information

Contract Number:

Contract Type: _________ Firm Fixed Price __________ Cost Reimbursement _________ Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

- 3 -

4. Contract Description:

Complexity of Work: ________ High ________ Med _________ Routine

How is this contract relevant to the requirement of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Reference to complete Blocks 5-8)

5. Client Information

Name:

Title:

Phone Number:

Email Address:

6. Describe the reference’s role in the project:

7. Date Questionnaire was completed (mm/dd/yy):

8. Client’s Signature:

The Government requests that the reference completes this Past Performance Questionnaire and submits directly to the Government. Completed Quesionnaire should be submitted to the following individual:

Name:

Email:

Fax:

Telephone:

- 4 -

PAST PERFORMANCE QUESTIONNAIRE

The following questions require you to circle whether the answer is “YES” or “NO”. If the question is not applicable, circle “N/A”. If the question is answered as “NO”, please provide an explanatory narrative. These narratives need not be lengthy, just descriptive. Space for narrative comments is included after each question and in the “Remarks” page of the survey. If more space is needed attach additional pages. You do not need to write a narrative for any questions answered as “YES” unless the question requests you to provide an explanation.

SCHEDULE

01. Was the Contractor responsive and timely in providing the required services? YES NO N/A

02. Was the Contractor responsive and timely to administrative functions of the contract?

YES NO N/A

03. Was the Contractor responsive and timely responding to questions or correspondence?

04. Was the Contractor in compliance with contract terms and conditions? YES NO N/A

05. Were any contract concessions/changes/terminations made due to the contractor’s failure to accurately plan? (If you answered “YES”, please provide an explanation).

- 5 -

MANAGEMENT OF KEY PERSONNEL

06. Did the Contractor appropriately prepare & train the personnel? YES NO N/A

07. Did the Contractor effectively manage subordinates? YES NO N/A

QUALITY OF SERVICES

08. Did the Contractor assimilate & accommodate changes in contractual requirements and/or priority effectively?

09. Did the Contractor exhibit knowledge of and comply with Government (or other) regulations?

10. Did the Contractor demonstrate technical expertise in providing all contractual services?

11. Did the Contractor possess/utilize tools/equipment necessary to adequately provide the required services?

- 6 -

QUALITY OF SERVICES (CONTINUED)

12. Did the Contractor meet the standard for:

(a) Technical Performance? YES NO N/A

(b) Administrative Performance? YES NO N/A

(c) Safety & Health? YES NO N/A

13. Has the Contractor ever failed to effectively control the quality of services provided? (If you answered “YES”, please provide an explanation).

14. Has a Contract Discrepancy Report (or equivalent) ever been issued? (If you answered “YES”, please provide an explanation).

15. Has a Cure Notice or Show Cause Letter ever been issued? (If you answered

“YES”, please provide an explanation).

16. Have there been any disputes/claims relative to the contract? (If you answered

“YES”, please provide an explanation).

17. Has the Contractor demonstrated the ability to correct any of the problems for questions 14 through 16? (If you answered “YES”, please provide an

- 7 -explanation).

QUALITY OF SERVICES (CONTINUED)

18. Has the contract been terminated for default? YES NO N/A

19. Has an election ever been made to not exercise an option due to the

Contractor’s poor performance? (If you answered “YES”, please provide an

BUSINESS RELATIONS

20. Did the Contractor satisfactorily manage subcontracts? YES NO N/A

21. Have there been any labor disputes? (If you answered “YES”, please provide an

22. Have there been any violations of Public Law, especially the Service Contract

Act? (If you answered “YES”, please provide an explanation).

- 8 -

23. Did the Contractor consistently provide prompt and courteous service? YES NO N/A

BUSINESS RELATIONS (CONTINUED)

24. Did the Contractor promptly and courteously resolve customer complaints? YES NO N/A

25. Did the Contractor’s actions show an overall commitment to customer satisfaction?

26. Did the Contractor satisfactorily provide overall cooperation relative to this contract?

27. How would you rate the integration and coordination of all activity needed to perform this contract?

28. Did you feel that the Contractor’s overall performance was satisfactory? YES NO N/A

29. Would you award similar contracts to this Contractor? YES NO N/A

- 9 -

- 10 -

REMARKS:

Please use this space if you needed more room than provided under the question. Label the remark with the applicable question number that it relates to.

- 11 -

Please list other known references regarding the Contractor’s performance:

TELEPHONE/

NAME ADDRESS FAX NUMBERS

- 12 -