Attachment 17 Past Perf Questionnaire.docx

SP4530-11-R-0001

JAPAN SCRAP

ATTACHMENT 17

PAST PERFORMANCE QUESTIONNAIRE

Note to Offeror: In accordance with Section L.39(a)(2), “The offeror shall forward Attachment 17, Past Performance Questionnaire, to each reference and instruct each reference to email the completed questionnaire, directly to the DLA Disposition Services Office, Pearl Harbor, Hawaii, ATTN: Mr. Nolan Horimoto, email: nolan.horimoto@dla.mil.

PAST PERFORMANCE QUESTIONNAIRE

We (offeror) are currently in the process of preparing our proposal for the DLA Disposition Services’ SOLICITATION NO. SP4530-11-R-0001, to provide Scrap / Waste Collection, Segregation, Transportation, and Disposal/Recycling located at Various Locations, Japan. Also included is the demilitarizing and demanufacturing of military items no longer needed.

As part of our proposal, we have listed you as a reference for work we performed for your company. Your input on our performance is therefore requested. Please complete this Questionnaire and email a scanned copy of your completed questionnaire to Mr. Nolan Horimoto, at email: nolan.horimoto@dla.mil. This Questionnaire is due no later than three calendar days after the closing date of the solicitation. If you have any questions regarding this requirement, please contact Mr. Nolan Horimoto, Contract Specialist, DLA Disposition Services, either by email or by phone at 808-473-1476. Thank you.

NAME OF OFFEROR: __________________________________________________________________________

Phone: ___________________________________ Fax: _______________________________

E-Mail: _________________________________________________________

PROJECT REFERENCED:

1. Contract or Identifying Number:

2. Description of scope of work and types of scrap or wastes involved. Be specific. Extremely important. Information will be used to determine relevancy of experience.

3. Period of Performance (Base) _________________________________ Amount $______________

Period of Performance (1st Option) _________________________________ Amount $______________

Period of Performance (2nd Option) _________________________________ Amount $______________

Period of Performance (3rd Option) _________________________________ Amount $______________

Period of Performance (4th Option) _________________________________ Amount $______________

TOTAL: $______________

4. Name of Person Completing Questionnaire: __________________________________________________

Agency/Company: ______________________________________________________________________

Title: _______________________________________ Phone: __________________________________

Fax: ______________________________ E-mail: ___________________________________________

EVALUATION. Please rate the Contractor utilizing the guide below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

1. TECHNICAL PERFORMANCE (QUALITY OF PRODUCT/SERVICE): The quality of service can be measured by the Contractor's Compliance with Contract Requirements and Accuracy of Reports and Documentation.

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

2. SCHEDULE (TIMELINESS): Schedule can be measured on Contractor’s Adherence to Performance Timeframes, Timeliness in Reporting Requirements, Timeliness in Submission of Closeout Documentation (Invoices w/supporting documents) and Responsiveness to Customer in Problem Resolution.

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

3. BUSINESS RELATIONS: Business relations can be measured by the Contractor's Reasonable and Cooperative Behavior, Professionalism of Staff, Prompt Notification of Problems, Effective Corrective Actions, Flexible and Productive in Problem Solving and Customer Satisfaction.

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

4. MANAGEMENT OF KEY PERSONNEL: Management of key personnel can be measured by the Contractor's Sufficient Allocation of Resources to Perform Contract Requirements, Effective Replacement of Key Personnel, Internal Communications Result in Effective & Efficient Management, and Responsiveness to Customer in Problem Resolution.

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

5. BASEL NOTIFICATIONS (WHERE REQUIRED): Basel Notifications can be measured by the Contractor's Skill in Applying for and Obtaining Basel Notifications, Knowledge of Competent Authorities, Successful Coordination with Transportation Sources to Minimize Number of Transit Countries and Skill in Working with Foreign Ministries when necessary.

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

6. Would you conduct business with this Contractor again? Yes [ ] Probably [ ] Probably not [ ] No [ ]

If probably not or no, please state why unless reasons have been previously stated.

7. What is your overall and final rating for this Contractor?

Exceptional [ ] Very Good [ ] Satisfactory [ ] Marginal [ ] Unsatisfactory [ ]

8. ADDITIONAL COMMENTS: