Attachment 3 Past Performance Questionnaire.pdf

SP3300-12-R-0023

PAST PERFORMANCE QUESTIONNAIRE

ATTACHMENT 3

REQUEST FOR PROPOSAL: SP3300-12-R-0023

The RFP has been issued to determine the most efficient and cost effective provider for this procurement. The place of performance for this contract is at the contractor’s facility and at the customer’s location, DLA Distribution Oklahoma City, OK.

The Defense Logistics Agency (DLA) is a United States (U.S.) Department of Defense (DOD) Agency that provides worldwide logistics support for the missions of the Military Departments and the Unified Combatant Commands under conditions of peace and war. DLA Distribution Oklahoma City, Oklahoma has a requirement for a Contractor to provide one Die Cutting Press including delivery and installation, all labor, and materials. The Contractor shall install the equipment at DLA Distribution Oklahoma City, Oklahoma, which is collocated on the Tinker Air Force Base Oklahoma. DLA Distribution Oklahoma City, Oklahoma is a tenant activity at Tinker Air Force Base Oklahoma. This acquisition is for one Die Cutting Press, including delivery, installation and training, for the container fabrication section located at DLA Distribution Oklahoma City, OK.

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:

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)

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WHEN 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 supply/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

Questionnaire Instructions The questionnaire covers the topics that are in line with the Contractor Performance Assessment Report (CPARs). This questionnaire is designed to provide basic information regarding the Contractor’s past performance results on the contracts they have been awarded and your satisfaction with their performance. The format of the questionnaire follows a five-point scale with five being Exceptional and 1 being Unsatisfactory.

RATERS PLEASE NOTE:

Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a lower than Satisfactory rating solely for not performing beyond the requirement of the contract.

Please use the following guide in preparing your response to the below questions:

Dark Blue/Exceptional – RATING OF 5 Definition: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

NOTE: To justify an Exceptional rating, identify multiple significant events and state how they were a 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.

Purple/Very Good – RATING OF 4 Definition: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

NOTE: 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.

Green/Satisfactory – RATING OF 3 Definition: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

NOTE: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified.

Yellow/Marginal – RATING OF 2 Definition: Performance does not meet some contractual requirements. The contractual performance of the element or sub-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.

NOTE: 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).

Red/Unsatisfactory – RATING OF 1 Definition: 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.

NOTE: 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).

How would you rate this contractor past performance using the following number scale, please ensure that you use the definitions above when assigning a numerical rating. In addition, please provide a justification for rating given if above or below satisfactory. Please CIRCLE your response below each question based on the following scale:

Dark Blue Purple Green Yellow Red Exceptional Very Good Satisfactory Marginal Unsatisfactory

QUALITY OF PRODUCT OR SERVICE:

Justification for Rating:

DELIVERY OR SCHEDULE:

COST CONTROL:

BUSINESS RELATIONS:

MANAGEMENT OF KEY PERSONNEL:

Justification for Rating:

UTILIZATION OF SMALL BUSINESS: (ONLY APPLICABLE TO LARGE BUSINESS CONTRACTORS)

ANY ADDITIONAL PERTINENT INFORMATION, i.e., SAFETY, SECURITY, AND ENVIRONMENTAL COMPLIANCE, MAINTENANCE OF GFE, etc.:

Please provide a brief description of the services/supplies provided under the contract administered by your organization:

Given what you know today, would you recommend award of this contractor?

YES NO

How would you rate this contractor’s past performance using the following number scale? In addition, please provide a justification for rating given if above or below mostly. Please CIRCLE your response below each question based on the following scale:

Always Almost Always Mostly Seldom Never

Meets Most Acceptable Performance Levels (APLs) and/or Contract Quality Standards

Always Almost Always Mostly Seldom Never

Justification:

Responds to Complaints in a Timely Manner

Always Almost Always Mostly Seldom Never

Justification:

Disputes the Scope of the Requirement

Always Almost Always Mostly Seldom Never

Justification:

Submits Reasonable Price Proposals on Contract Changes

Always Almost Always Mostly Seldom Never

Justification:

Has Problems with Payroll, Paying for Supplies, or Subcontractors

Always Almost Always Mostly Seldom Never

Justification:

Difficult When Negotiating Changes

Always Almost Always Mostly Seldom Never

Justification:

Pro-actively Anticipates, Avoids or Mitigates Problems

Always Almost Always Mostly Seldom Never

Justification:

Billing is Timely, Accurate and Complete

Always Almost Always Mostly Seldom Never

Justification:

Please provide any additional information regarding this contractor’s performance, if applicable:

Evaluator: Company/Organization Name/Address

Evaluator’s Name: ______________________________________________________________

Evaluator’s Telephone Number: ___________________________________________________

PART III – RETURN INFORMATION

Please return this completed Questionnaire to the Contract Specialist, via e-mail (kimberly.lecates@dla.mil) by the date and time specified under the Instructions to Offerors, paragraph two (2).

DATE OF COMPLETION & SUBMISSION: _____________________

ATTACHMENT 3