Attachment_0010_-_Past_Performance_Questionnaire.docx

Past Performance Assessment Questionnaire Please provide your candid response to the following questions IAW the Past Performance Questionnaire Letter. The information that you provide will be used in the awarding of federal contracts. Therefore it is important that your information be as factual and accurate as possible. If you do not have the appropriate knowledge with the company in question, please forward this questionnaire to the person who does. Upon completion of this questionnaire, please forward by electronic email to ATS III mailbox at usarmy.detroit.acc.mbx.wrn-atsiii@mail.mil by TBD. Thank you for your assistance.

PART I - IDENTIFICATION (To be completed by the Offeror)

A. RELEVANT CONTRACT

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract/Task Order Number:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Contract Period of Performance End Date:

Forecasted or Actual Contract Completion:

Brief Description of the Relevant Contract Scope:

B. OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

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

RATING SCALE & DEFINITIONS

Table 1 identifies the rating scale and descriptions. Please apply the rating that most closely matches your assessment for each area of consideration listed below. Please include a written narrative for each rating applied, utilizing the adjectival rating definition in Table 1.

Table 1

1. Quality of Targetry and Targetry System Provided:

Assess the quality of the contractor’s targetry devices (i.e. Stationary Infantry Targets (SITs), Moving Infantry Targets (MITs), and Stationary Armor Targets (SATs)) and how the targetry devices have worked with Targetry Range Automated Control and Recording (TRACR) software to perform as a whole system. This assessment shall include negative or positive information on how, the contractor’s targetry system and devices performed during acceptance testing and how well the system has performed since it was accepted (i.e. minimal or significant downtime on all or parts of the range, limited or excessive amounts of warranty claims, warranty responsiveness after warranty claims were formally filed, etc.)

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only some somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

2. Project Schedule:

Assess the contractor’s ability to deliver on time and meet all schedule requirements of the contract. This assessment of the contractor’s adherence to the required performance schedule should include the contractor’s efforts that contributed, negatively or positively, to the completion of the project on time.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues such as delays or extensions granted give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only some somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. delays by the customer/end user, changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor (e.g. unusually severe weather or default of a subcontractor beyond the control of both the Contractor and subcontractor).

3. Management / Business Relations:

Assess the efforts of contractor management and describe the following: whether control measures were adequate to provide a product which conforms to contract requirements; any deficiencies or noncompliance with contract requirements; if corrective actions had to be taken, how effective was the contractor in implementing action plans to any identified deficiencies or noncompliance with contract requirements; how effective was the contractor in managing subcontracts; and how sufficient was contractor staffing.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only some somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

PART III - RESPONDENT IDENTIFICATION

Please provide a point of contact who compiled or completed this questionnaire and who, if needed, may be contacted by our evaluation team regarding the information provided in this questionnaire.

Organization:

Name:

Title:

Date:

Telephone Number:

Address:

Fax Number:

E-mail Address:

Once Filled In, this document is considered Source Selection Information – See FAR 2.101 and FAR 3.104 image1.emf image2.png