SOL_W15QKN16R0002_PLS_ATTACH_0039_PAST_PERFORM_QUES_02MAR2017.docx
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Solicitation W15QKN-16-R-0002 Personnel Life-Cycle Support (PLS) Attachment 0039 – Past Performance Questionnaire
PAST PERFORMANCE EVALUATION – QUESTIONNAIRE FORM
02 MARCH 2017
The Army Contracting Command-New Jersey is currently conducting a competitive source selection to evaluate Offerors on Solicitation Number W15QKN-16-R-0002 for Human Resource Personnel Lifecycle Support Services. As part of this evaluation, we have requested that the Offerors provide information about their past performance on same or similar federal, state or local government or commercial contracts as compared to North American Industry Classification System (NAICS) 541612. You have been identified as the point of contact cited on the enclosure.
Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the Army Contracting Command – New Jersey, ATTN: Joseph Haslach, Contract Specialist, 5418 South Scott Plaza, Joint Base MDL, NJ 08640-5003, NO LATER THAN 1:00 PM (Local Time for Joint Base MDL, New Jersey) on 16 March 2017. Your questionnaire may be submitted electronically to Joseph.m.haslach.civ@mail.mil.
Your cooperation is greatly appreciated. Questions may be directed to Joseph Haslach at Joseph.m.haslach.civ@mail.mil or the undersigned at Cynthia.j.geiss.civ@mail.mil.
Sincerely, Cynthia Geiss Contracting Officer Army Contracting Command – New Jersey
APPENDIX D – PAST PERFORMANCE
ENCLOSURE 2 – PAST PERFORMANCE EVALUATION – QUESTIONNAIRE FORM
Contractor: ____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________
| POC: ________________________ | Title: ________________________ | |
| (Name) | (e.g. PCO/ACO/TM) |
(Agency, Telephone No., E-mail Address & Fax Number) The following questions pertain to the contractor’s record of past (five years prior to October 21, 2016) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.
Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.
Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.
Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.
PART I. (To be completed by the Offeror)
A. CONTRACT IDENTIFICATION
Contractor/Company Name/Division:
Address:
Program Identification/Title:
Contract Number:
Contract Type:
Prime Contractor Name (if different from the contractor name cited above):
Contract Award Date:
Forecasted or Actual Contract Completion Date:
Nature of the Contractual Effort or Items Purchased:
B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE
Name:
Title:
Date:
Telephone Number:
Address:
E-mail Address:
PART II. EVALUATION (To be completed by Point of Contact – Respondent) A. Compliance and Performance of Services Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below) Comments:
B. Adherence to Cost or Price Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below)
C. Adherence to Service and Deliverables’ Schedules
Good Acceptable Marginal (Explanation must be provided in Comments field below)
D. Program Management (including Management of Subcontractors).
Good Acceptable Marginal (Explanation must be provided in Comments field below)
E. Personnel Recruitment and Retention
Good Acceptable Marginal (Explanation must be provided in Comments field below)
F. Timeliness of Performance of Services and Product Deliverables.
Good Acceptable Marginal (Explanation must be provided in Comments field below)
G. Business Relations
Good Acceptable Marginal (Explanation must be provided in Comments field below)
H. General Comments. Provide any other relevant performance information.
I. Other Information Sources. Please provide the following information:
Are you aware of other relevant past efforts by this company?
If yes, please provide the name and telephone number of a point of contact:
J. Respondent Identification. Please provide the following information:
Organization:
Name:
Title:
Date:
Telephone Number Address:
E-mail Address:
PART III. RETURN INFORMATION
Please return this completed Questionnaire via e-mail to the Contracting Officer identified in the cover letter.
Thank you for your assistance.
| _________________________________ | ____________________ | |
| Signature | Date |
Typed or Printed Name
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