Attachment_4_Past_Performance_Questionnaire.pdf

SP3300-18-R-5005

Attachment 4

(WHEN COMPLETED)

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

(WHEN COMPLETED)

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

Present/Past Performance Questionnaire

PART I – BACKGROUND

The RFP has been issued to solicit offers that would provide the best value to the Government for the requirements of the procurement. The specific RFP requirements may be referenced at www.fbo.gov. This requirement is for Transportation support capability in the Arabian Peninsula that would serve as the primary conduit for cargo in support of the Trans Arabian Network (TAN). A company that is interested in providing an offer on the RFP has requested that you complete this present/past performance questionnaire and submit it to the following:

RETURN INFORMATION: Email the completed questionnaire to the Acquisition Specialist, Brian Rose at brian.rose@dla.mil.

All completed questionnaires shall be submitted via email to the Acquisition Specialist noted above by the proposal due date and time referenced in the solicitation.

PART II – QUESTIONNAIRE INSTRUCTIONS

This questionnaire covers the topics that are in line with the Contractor Performance Assessment Reporting System (CPARS). This questionnaire is designed to provide basic information regarding the Contractor’s present/past performance results on the contracts they have been awarded with your company and your satisfaction with their performance.

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:

Exceptional 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 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 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.

http://www.fbo.gov/

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SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

(WHEN COMPLETED)

FOR OFFICIAL USE ONLY

Satisfactory 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.

Marginal 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).

Unsatisfactory 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).

Not Applicable Definition: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

PART III - PERFORMANCE ASSESSMENT

Please CIRCLE or HIGHLIGHT your response below each question based on the following scale:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable In addition, please provide a justification for rating given if above or below satisfactory.

1. QUALITY OF PRODUCT OR SERVICE:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable Justification for Rating:

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SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

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2. TIMELINESS OF PERFORMANCE/SCHEDULE:

3. COST CONTROL:

4. GOOD BUSINESS RELATIONS:

5. MANAGEMENT OF KEY PERSONNEL:

6. UTILIZATION OF SMALL BUSINESS: (ONLY APPLICABLE TO LARGE BUSINESS

CONTRACTORS)

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable Justification for Rating:

7. REGULATORY COMPLIANCE:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable Justification for Rating:

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

Please CIRCLE or HIGHLIGHT your response below each question based on the following scale:

Yes No

In addition, please provide an explanation when necessary.

9. MEETS MOST ACCEPTABLE PERFORMANCE LEVELS (APLs) AND/OR

CONTRACT QUALITY STANDARDS:

If no, please explain:

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SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

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10. RESPONDS TO COMPLAINTS IN A TIMELY MANNER:

11. DISPUTES THE SCOPE OF THE REQUIREMENT:

If yes, please explain:

12. SUBMITS REASONABLE PRICE PROPOSALS ON CONTRACT CHANGES:

If no, please explain:

13. HAS PROBLEMS WITH PAYROLL, PAYING FOR SUPPLIES, OR

SUBCONTRACTORS:

14. DIFFICULT WHEN NEGOTIATING CHANGES:

15. PRO-ACTIVELY ANTICIPATES, AVOIDS, OR MITIGATES PROBLEMS:

16. BILLING IS TIMELY, ACCURATE, AND COMPLETE:

17. IF GIVEN A CHOICE, WOULD YOU AWARD TO THIS CONTRACTOR AGAIN:

18. PLEASE PROVIDE ANY ADDITIONAL INFORMATION REGARDING THIS

CONTRACTOR’S PERFORMANCE, IF APPLICABLE:

(WHEN COMPLETED)

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SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104

(WHEN COMPLETED)

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PART IV - GENERAL PROGRAM INFORMATION

RELEVANT PREVIOUS CONTRACT -- IDENTIFICATION

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

Contract Original Dollar Amount: ____________________ Contract Current Dollar Amount: ____________________ Contract Original Period of Performance: ______________ Contract Current Period of Performance: ______________ 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: ____________________

Evaluator’s Name: _____________________Evaluator’s Signature: ________________________ Evaluator’s Title: ___________________Evaluator’s Telephone Number: ___________________ Agency or Business: ______________________________________________________________ Address:

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SOURCE

SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104.

Present/Past Performance Questionnaire