Attachment_0004_Past_Performance_Questionnaire.pdf

Attachment 0004 - Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE COVER SHEET

(NOTE TO OFFEROR: For each past performance questionnaire to be completed by a client and submitted to the

Government as a reference, provide a copy of this cover sheet with your proposal identifying the client’s point of contact information. Ensure correct phone numbers and email addresses are provided for the client point of contact.)

1. OFFEROR: ______________________________________________________________

2. CONTRACT NUMBER/AWARD DATE: ______________________________________

3. SERVICES PROVIDED: ____________________________________________________

4. CONTRACT AMOUNT: ____________________________________________________

5. QUANTITY AND MONTHLY DELIVERY RATE: _______________________________

6. BUYING ACTIVITY OR COMPANY AND MAILING ADDRESS: __________________

7. POINTS OF CONTACT:

a. NAME & TITLE: ________________________________________________________

b. PHONE NUMBER: ______________________________________________________

c. EMAIL ADDRESS: ______________________________________________________

PAST PERFORMANCE QUESTIONNAIRE – RELEVANCY RATINGS AND CONFIDENCE ASSESSMENTS TO

BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Past Performance Relevancy Ratings

Rating Definition

Very Relevant Present/past performance effort involved essentially the same scope and magnitude of effort and complexities this solicitation

Requires.

Relevant Present/past performance effort involves similar scope and magnitude of effort and complexities this solicitation requires

Somewhat Relevant Present/past performance effort involves some of the scope and magnitude of effort and complexities this solicitation requires

Not Relevant Present/past performance effort involves little or none of the scope and magnitude of effort and complexities this solicitation requires.

Performance Confidence Assessment Ratings

Rating Description

Substantial Confidence Based on the Offeror’s recent/relevant performance record, the

Government has a high expectation that the Offeror will successfully perform the required effort

Satisfactory Confidence Based on the Offeror’s recent/relevant performance record, the

Government has a reasonable expectation that the Offeror will successfully perform the required effort

Limited Confidence Based on the Offeror’s recent/relevant performance record, the

Government has a low expectation that the Offeror will successfully perform the required effort.

No Confidence Based on the Offeror’s recent/relevant performance record, the

Government has no expectation that the Offeror will be able to successfully perform the required effort

Unknown Confidence

(Neutral)

No recent/relevant performance record is available or the Offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned

PLEASE CHECK THE ADJECTIVAL RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE

CONTRACTOR’S PERFORMANCE

1. Was this a competitive contract?

2. Role of the Contractor?

3. Ability to meet quality standards specified for technical performance or materials delivered?

4. Compliance with contractual terms and conditions.

Confidence

5. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

6. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports).

tantial Confidence

7. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

8. Did the Contractor comply with the original period of performance? If not, what was the actual time compared to the original time?

Explain:

9. If slippage occurred in the timeliness of delivery or period of performance, the contractor provided reasons for those slippages and whether a revised schedule was incorporated.

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10. Ability to successfully respond to emergency and/or surge situations.

11. Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

12. Ability to hire/apply a qualified workforce to this effort.

13. Ability to retain a qualified workforce on this effort.

14. Did the Contractor encounter any quality related issues? If so, what were they?

15. Were any Quality Discrepancy Reports (QDRs) issued? If so, was corrective action taken?

16. If quality issues occurred, the contractor provided data adequately explaining corrective actions that were taken to improve their process and/or solve their quality problems.

17. If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if a show cause or cure notices were issued or any default action in comment section below.

18. Have there been any indications that the contractor has had any financial problems?

19. In summary, provide an overall rating for the work performed by this contractor.

COMMENTS: Objective Comments/Concerns related to this Offeror:

Signature Date

Thank you for your prompt response and assistance.

Please return this completed questionnaire to Ms. Trisha Polfliet, trisha.l.polfliet.civ@mail.mil and

Ms. Danette Wilson, danette.d.wilson.civ@mail.mil, prior to the solicitation closing date and time.

mailto:trisha.l.polfliet.civ@mail.mil mailto:danette.d.wilson.civ@mail.mil