Tab_12_SPE4AX-16-R-0004_Bearings_RFP_Attachment_7_-_Past_Performance_Questionnaire.docx

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

Present / Past Performance Questionnaire

(TO BE COMPLETED BY Relevant POC)

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name / Signature and Role Relative to Contract (e.g. Buyer, Program Manager):____________________________________________________________________________________________________________

Agency or Business: __________________________________________________________________________________________________________________________________________________________________________________________________________________________

Address: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Telephone Number: _______________________________

Fax No. ____________________________________

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SENSITIVE AND SHALL NOT BE RELEASED TO THE OFFEROR.

Part I. SPECIFIC PROGRAM INFORMATION

Contractor / Business: _____________________________________________ Contractor and Government Entity (CAGE) Code: __________

Program Title and Brief Description: _______________________________________________________________________________________________________________________________________________________________________________________________________

Contractor’s Role in the Program: _____Prime _____Subcontractor _____Vendor / Supplier

Contract Number: _________________ Number of Years: Basic:_____ Option:______ Contract Type(s): List all applicable contract types, i.e. Firm-Fixed-Price, Time & Materials, Cost, etc.___________________________________________________________

PART II. GENERAL PROGRAM INFORMATION

Period of Performance:

1. Original Schedule (assuming all options exercised): Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised): Beginning Date _________ through ____________

3. Reason for difference (if applicable) _________________________________________________________________

Contract Dollar Value:

1. Original MAX Contract $ Value (assuming all options exercised):___________________

2. Current MAX $ Value (assuming all options exercised): _____________________

3. Primary Causes of Changes: __________________________________________________________________

NOTE: In Part III, should your response be other than “satisfactory,” please provide supporting documentation in “Additional Remarks” on page 4 of 5.

PART III. PERFORMANCE ASSESSMENTS

Please indicate the appropriate rating for each of the following questions in table below:

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N / A NOT APPLICABLE: 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.

1. On-Time Delivery (OTD): Items on the contract delivered in accordance with the terms of the contract

2. Quality: Items delivered conformed to the specifications of the contract

3. Product Quality Deficiency Reports (PQDR): Quality problems were resolved adequately:

4. Data: Contractor had adequate ability to read and interrupt level 3 drawings:

5. Level of business electronic data exchange supported by the contractor was adequate for contract reporting, pricing, payment, tracking for analysis purposes:

6. Timely recognition and notification of obsolescence and diminishing manufacturer issues:

7. Company performed independently without significant customer direction / oversight:

8. Extent to which Company’s services met the specification / performance requirements:

9. Post-award requests for technical information was adequate:

10. Did the contract require a first article or pre-production sample? If yes, was it delivered timely and without quality problems?

11. Were any PQDRs issued against the contract? If yes, explain. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. Has action been initiated to cancel or terminate the contract for default? If yes, explain. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

13. Have there been any disputes / claims relative to the contract? If yes, explain.

14. Describe the contractor’s or company’s strong and/or weak points identified as a result of technical performance and any technical performance risk identified during the life of the contract. _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Do you feel you “got what you paid for”? Please explain. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

16. If given a choice, would you award to this contractor again? If not, please explain. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

17. Additional Remarks

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY