Final Attachment_J 3_Past_Performance_Questionaire.docx

SP3100-09-R-0013

ATTACHMENT J.3

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER: SP3300-11-R-0006

An offeror has provided this questionnaire to you (the Respondent) based upon previous work that they have accomplished for you. The offeror considers this to be relevant experience for the work involved in this solicitation. The Government will evaluate relevant past performance of each offeror in making its award determination. This questionnaire is one way for the Government to obtain such information.

Please provide your candid responses. It is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by Government evaluators. However, the Government may contact you for follow-up information. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does or notify the Contract Specialist identified below immediately. Thank you.

PART I (To be completed by the Offeror)

A. RELEVANT PREVIOUS CONTRACT -- IDENTIFICATION

Contractor/Company Name/Division:

Contract Place of Performance (Address):

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if this was a subcontract effort):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Method of Acquisition (competitive or noncompetitive) Nature of Award (initial or follow-on) Nature of the Contractual Effort or Items Purchased:

Awarded Contract Price/Cost:

Final Contract Price/Cost:

B. OFFEROR’S POINT OF CONTACT FOR RESPONDENT QUESTIONS

Name:

Title:

Telephone Number:

FAX Number:

E-mail Address:

C. DATE SENT TO RESPONDENT: ________________

PART II – EVALUATION (TO BE COMPLETED BY RESPONDENT)

What filled in this document is SOURCE SELECTION SENSITIVE IAW FAR 2.101 and 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: _____________________________________________________________

B. Contract number: ______________________

C. Contract type: ______________________________

D. Was this a competitive contract? Yes _____ No _____

E. Period of performance: ___________________

F. Initial contract cost: $____________________________

G. Current/final contract cost: $_______________________________

H. Reasons for differences between initial contract cost and final contract costs:

I. Description of service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name:

B. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name and title: ____________________________________________________________________________________

B. Evaluator's phone/fax number: _________________________________________________________

C. Number of years evaluator worked on subject contract: ____________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

O OUTSTANDING - The contractor has demonstrated an outstanding performance level that was significantly in excess of anticipated achievements and is commendable as an example to others, so that it justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as “Excellent”.

E EXCELLENT – The contractor has substantially exceeded the contract performance requirements.

G GOOD – There are no, or very minimal issues and the contractor has met the contract requirements.

F FAIR – Overall compliance requires minor agency resources to ensure achievement of contract requirements.

P POOR – Overall compliance requires significant agency resources to ensure achievement of contract requirements.

U UNSATISFACTORY – Non-conformances are jeopardizing the achievement of contract requirements, despite use of agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements.

N NOT APPLICABLE - Unable to provide a score.

Ability to perform strict accountability and life-cycle management of all HM (Hazardous Material) products by specific chemical constituents from cradle to grave.

Ability to perform HW (Hazardous Waste) handling, documentation, and disposition, as required.

Ability to perform decanting and dispensing of bulk HM products, as required.

Ability to Maintain Government-approved Authorized User (customer) and Use (products) lists (AUL) in HMMS (Hazardous Materials Management System).

Ability to perform annual utilities systems preventative maintenance and repair within the recommend time, as set by manufacture.

Ability to Perform tracking of empty and partial containers and update HMMS database accordingly

Ability to ensure continual ESOH (Environmental Safety and Occupational Health) compliant HM management in accordance with ISO 14001 Standards.

Ability to maintain GFE (Government Furnished Equipment) condition accepted and to maintain inventory control and accountability of all GFE.

Ability to perform strict accountability and life-cycle management of all HM products by specific chemical constituents from cradle to grave.

Quality control measures such as implementation of a quality control plan that identifies methodologies to include identification of lot sizes, sample sizes, accept/reject rate for conducting and documenting quality surveillance; identifying and implementing corrective actions if deficiencies are found and updating quality control plan as needed or at least on an annual basis.

Ability to submit reports with accuracy and completeness on time.

Ability to Operate Issues Centers (IC) (includes managing HM carts and lockers) as required.

Ability to plan and cope with surge requirements/daily workload fluctuations.

Ability to respond to high priority and emergency service requests with the right person to do the job in the timeframes allotted.

Workload planning ability.

Adherence to contract delivery schedule.

Ability to complete inventories on schedule.

Ability to meet timeliness standards.

Ability to provide required training to obtain and maintain required licenses and certifications.

Ability to meet proposed cost estimates.

Financial management practices (payroll, supplier payments, timely and accurate invoicing, etc.) and their impact on this contract.

Submittal of reasonable priced proposals on contract changes.

Performance in providing accurate, timely and complete billing.

Ability to resolve problems.

Communications with the Quality Assurance Organization, Corporate Headquarters, Contracting Officer, etc.

Professionalism.

Responsiveness to customer complaints and questions.

Intuitiveness to perceive customer needs/problem areas and provide solutions prior to customer complaints.

Ease in negotiating.

Ability to coordinate, integrate and provide effective subcontractor management.

Ability to anticipate, avoid or mitigate problems.

Overall contract management.

Ability to retain key employees.

Ability to replace or add additional key employees.

Effectiveness of assigned key personnel in terms of the appropriate mix of education and experience to accomplish the requirement.

Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes___ Default___ Convenience___ Pending Terminations___ No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

What were the contractor’s greatest strengths in the performance of the contract?

What were the contractor’s greatest weaknesses in the performance of the contract?

Would you hire this contractor in the future to perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

Thank you for your prompt response and assistance!

PART III – RETURN INFORMATION

Please return this completed Questionnaire to the Contract Specialist, Eric Berns, via e-mail at eric.berns@dla.mil or fax (717) 770-5689 within 3 days of receipt. Questionnaires must be received by the Contract Specialist, Eric Berns, by the proposal due date and time specified in Section L-17, Paragraph 2.

DATE OF COMPLETION & SUBMISSION: _____________________