USS TRIPOLI Attachment S-9 Past Performance Questionnaire.docx

USS TRIPOLI (LHA 7) FY23 SRA

Attachment S-9: Past Performance Questionnaire

Instructions to Offeror

Completed questionnaires shall be forwarded directly to the Naval Sea Systems Command (NAVSEA) point of contact(s) listed below by the evaluator:

PCO Name: CDR Jon PagnuccoWarren Beckman PCO Phone Number: 202-781-1024warren.m.beckman.civ@us.navy.mil PCO Email: jonathan.p.pagnucco.mil@us.navy.mil202-781-0088

Note: Completed Questionnaires received from offerors are not acceptable.

Instructions to Evaluator

NAVSEA is requesting an evaluation of an Offeror’s past performance for source selection purposes. Accordingly, request your candid assessment of the Offeror’s past performance; please see Section A below for the identity of the Offeror and contract of interest.

Once completed, this questionnaire and any appended information becomes Source Selection Sensitive and must be protected from disclosure. Access to this information shall be limited to Government procurement officials.

Hand-written evaluations are acceptable. Please answer each question in SECTION B by selecting one of the ratings listed below, where:

E – Exceptional: Contractor performance substantially exceeded expected levels of performance.

V - Very Good: Contractor performance exceeded expected levels.

S – Satisfactory: Performance met expected levels.

M – Marginal: Performance was less than expected.

U – Unsatisfactory: Performance was significantly less than expected.

N/A – Not Applicable

In addition, please provide supporting comments for each rating. Please use your supporting comments to highlight the Offeror’s specific strengths and weaknesses. The evaluator comments field in Section B will expand as necessary when text is entered. Your ratings and comments should reflect only “contractor liable” performance. You may supplement your knowledge with the knowledge and judgment of others in your organization.

Please enter the requested information in SECTION C for the person primarily responsible for completing the questionnaire, provide your signature, then transmit the completed questionnaire to the point of contact identified above. Thank you for your assistance in this matter.

DO NOT PROVIDE COMPLETED QUESTIONNAIRES TO THE OFFEROR UPON COMPLETION

Section A (To be completed by the Offeror) Name of Offeror/Contractor:

Address of Offeror/Contractor:

Contract Number (between Prime and Sub):

Task or Order No., where applicable:

Contract No. (between Government and Prime):

Task/Order No., where applicable:

Period of Performance:

Place of Performance:

Description of Work/Scope of Effort (max. 50 words):

Address:

Phone:

Fax:

Email:

Method:

Section B (To be completed by Evaluator)

Overall Contract Outcome: Ability to satisfactorily complete all tasks while conforming to customer requirements, standards of good workmanship and safe practices.

Cost Performance: Ability to accurately forecast and control costs throughout all phases of the contract.

Schedule Performance: Ability to develop accurate work schedules and adhere to those schedules, as well as the ability to adapt to changes in requirements and work schedules.

Technical Performance (Quality of Product): Ability to overcome technical challenges by applying sound engineering principles, complete required engineering analyses, and develop adequate technical reports & plans.

Subcontracting Plan Adherence and Coordination: If a subcontracting plan was required, please describe the offerors success in meeting planned goals and/or efforts made to overcome goal deficiencies and challenges as well as the offeror’s ability to successfully manage and integrate subcontractors.

Section C (To be completed by Evaluator)

Name of Evaluator:

Position/Title:

Administrating Authority/Agency:

Phone:

Fax:

Email:

Signature: Date:

Attachment S-9: Past Performance Questionnaire image1.emf