W564KV-18-R-0003_Past_Performance_Questionnaire.docx

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor:____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________

(Agency, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor’s record of past (within the past three years) 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 of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· 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. Effectiveness of Project Management (to include use and control of subcontractors).

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

C. Timeliness of Performance for Services and Product Deliverables.

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

F. General Comments. Provide any other relevant performance information.

G. 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:

H. Respondent Identification. Please provide the following information:

Organization:

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.

Typed or Printed Name

TELEPHONE INTERVIEW QUESTIONNAIRE FORM

Contractor:____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________

(Agency, Telephone No., E-mail & Facsimile No.)

If conducting a telephone interview:

“Hello, I am ______________________. I am calling in reference to Contract ____________________ with a company called ________________________. My questions will pertain to the contractor’s record of past, which is defined as within the past three years, 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. A summary of this discussion may be sent to you for your records. 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.

The following questions pertain to the contractor’s record of past (within the past three years) 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

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

C. Timeliness of Performance for Services and Product Deliverables.

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

F. General Comments. Provide any other relevant performance information.

G. 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:

H. Respondent Identification. Please provide the following information:

Organization:

Title:

Date:

Telephone Number Address:

E-mail Address:

Record of Interview: (to be filled out by PPT member)

( ) Discussed recentness and relevance of information

TELEPHONE INTERVIEW REPORT FORWARDING MEMORANDUM

Contracting Office

MEMORANDUM FOR

SUBJECT: Telephone Interview Report

1. Enclosed is a summary of your telephone conversation, (date), with a member of a Past Performance Team at this Command.

2. It is requested that you review and verify the accuracy of this report and e-mail or fax it to us by (date). It is extremely important that you respond by this date so Army readiness will not be compromised. If we do not hear from you by the day indicated above, we will consider the summary of the discussion official.

3. We would like to thank you in advance for your time and assistance regarding this acquisition. If you have any questions or comments, you may address them to the Contract Specialist at XXX-XXX-XXXX or fax to XXX-XXX-XXXX.

CONTRACTING OFFICER

Encl(1)

PERFORMANCE CONFIDENCE ASSESSMENT

INDIVIDUAL EVALUATOR REPORT

PERFORMANCE CONFIDENCE ASSESSMENT

Solicitation No.:

EVALUATOR’S NAME: OFFEROR:

solicitation REFERENCES:

FACTOR:

PROPOSAL/PROJECT DESCRIPTION:

Evaluation Rating:

(Insert appropriate rating from applicable adjectival rating; e.g., Substantial Confidence, Satisfactory Confidence, Limited Confidence, No Confidence, Unknown Confidence (Neutral)) Consider relevancy assessment/quality of performance as it relates to the reference/project.

Evaluator’s Rating:

Initial Rating:__________ Evaluator Initials/Date: _____ Factor Chairperson Initials/Date: _____ Interim:________________ Evaluator Initials/Date: _____ Factor Chairperson Initials/Date: _____ Final Rating:____________ Evaluator Initials/Date: _____ Factor Chairperson Initials/Date: _____

1. RATIONALE: Include supporting rationale when applying the evaluation rating definitions. The Rating results from the merging of assessment information on (a) the extent of relevance/recency of current/prior contracts and (b) the quality of current/prior performance).

1. Support the Performance Confidence Assessment with your evaluation results in terms of overall findings (with specific strengths, weaknesses, uncertainties, risks, and deficiencies below.) Identify (e.g. Initial Rating (IR), Interim Evaluation Report (IER)), or Final Rating (FR). Use continuation sheets as needed

STRENGTHS:

(Precede the strength with an (S) if it identifies a significant strength. Address any risks associated with the strength.)

WEAKNESSES(identify EN number(s) for each one):

(Precede the weakness with an (S) if it identifies a significant weakness. Address the risks associated with the weakness.)

DEFICIENCIES(identify EN number(s) for each one):

UNCERTAINTIES:

EVALUATION NOTICES (ENs) required for each weakness, significant weakness, deficiency/uncertainty

TEAM EVALUATION CONSENSUS FORM

PERFORMANCE CONFIDENCE ASSESSMENT

OFFEROR:__________________________ DATE:_________________________

CONSENSUS AGREEMENT

The Past Performance Evaluation Team has completed the interview and assessment process for the above named offeror. This assessment takes into consideration the quality/ relevance of the Offeror’s performance for projects/references provided as well as information as documented from any other sources considered.

A confidence assessment rating of ________________________ has been assigned to the aforementioned offeror.

The following is a summarization of the team’s findings (including strengths, weaknesses, deficiencies and uncertainties):

APPENDIX E

GUIDELINES FOR WRITING EVALUATION NOTICES (ENs)

1. In the competitive procurement, your job is not to get the contractor to submit the best possible proposal. Your job is to evaluate the proposal submitted; obtain additional information (through the SSEB Chairperson/PCO) from the contractor when needed to perform this process; document your evaluation/assessment; and evaluate/assess the Final Revised Proposal (if any) including responses to the evaluation notices. The Government’s obligation during discussions is to call the contractor’s attention to all deficiencies, uncertainties, significant weaknesses and weaknesses at least once.

2. Always reference the solicitation, proposal and prior related ENs when writing a notice. This provides an excellent method of tracking the finding.

3. Do not use adjectives (e.g. poor) which require some comparison to an unknown standard in order to establish the meaning of the objective, nor use the adjectival rating within the narrative (e.g. outstanding solution).

4. Remember to write the ENs so that, to the extent possible, contracting and legal can understand them as well as the offeror.

5. If the solicitation establishes a firm requirement, the offeror’s proposal must not deviate from the requirement. In writing a deficiency EN, reference the solicitation requirement, offeror’s proposal (if appropriate) and state that offeror has failed to comply with a firm requirement of the solicitation.

6. If the solicitation does not establish a firm requirement, you may not suggest or imply ways to improve the proposal. You should identify significant weaknesses and weaknesses and explain why the Government considers it to be a weakness. Include reference to the proposal and solicitation (if appropriate).

7. If you believe the Government’s PWS/requirement is in error or deficient, do not attempt to get the offerors to cure it in their proposal by an EN. Instead, bring it to the attention of the SSEB Chairperson or PCO immediately.

8. For ENs, do not discuss the impact to the Government should the proposal be accepted. Such qualifications are for internal Government evaluations. The purpose of the EN is to call the offeror’s attention to the finding. The degree of impact should only be identified in your evaluation report.

9. Whenever possible write the EN in an unclassified form. Instead, include the classified information location in the solicitation or proposal.

APPENDIX F

EVALUATION NOTICE (EN) FORM - CLARIFICATION

OFFEROR: _____________________________________________

EN NUMBER: _________________ DATE: _________________________

1. SOLICITATION AND PROPOSAL REFERENCES (Cite page and paragraph numbers)

a. SOLICITATION:

b. PROPOSAL:

2. REASON FOR SUBMISSION:

(Specify type of finding. See Section IV of this document for definitions.)

3. STATEMENT OF PROBLEM:

EVALUATION NOTICE (EN) FORM - DISCUSSION

OFFEROR: _____________________________________________

EN NUMBER: _________________ DATE: _________________________

1. SOLICITATION AND PROPOSAL REFERENCES (Cite page and paragraph numbers)

a. SOLICITATION:

b. PROPOSAL:

2. REASON FOR SUBMISSION:

(Specify type of finding. See Section IV of this document for definitions.)

3. STATEMENT OF PROBLEM:

EVALUATION OF EN RESPONSE FORM

1. OFFEROR:

2. EN NUMBER:

3. PROPOSAL REFERENCE:

4. EVALUATION OF RESPONSE:

APPENDIX G

SAMPLE MAJOR MILESTONE SCHEDULE

SOURCE SELECTION INFORMATION (SEE FAR 3.104)