A.08 Exhibit A Past_Performance_Questionnaire.doc

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Attached to
Small Laboratory Research Animals
Solicitation number
W81XWH19R0051
Issued by

About this file

This document contains a past performance questionnaire template and information on a multiple award blanket purchase agreement solicitation for small laboratory research animals. The questionnaire is to be completed by references to evaluate offerors' past performance on contracts for items like mice, rats, rabbits, guinea pigs, hamsters and gerbils. It requests details on the contractor, contract type and period of performance, and uses a scale to rate elements such as understanding requirements, resolving problems, personnel management, and recommendation to award again. The solicitation is for these same small animals to support research at Army and Defense Health Agency facilities from biosafety levels one through four. It will result in multiple BPAs for purchases over an indefinite delivery period.

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PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

U.S. ARMY MEDICAL RESEARCH ACQUISITION ACTIVITY

Fort Detrick, MD

The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting proposals in response to the RFP W81XWH-19-R-0051. The information you provide will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s).

a.

Please complete all sections of the attached questionnaire. Include your name and title, organizational address, e-mail address, telephone and fax number.

b.

Include the contractor’s name and address, the title and/or description of the type of work performed, the award number, the value of the contract (including options), the award and completion date of the project and the type of award/solicitation.

c.

Use the rating scale found on the bottom left corner of the questionnaire to rate each performance element.

d.

Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments. Clear handwritten responses are sufficient.

e.

Please e-mail your response to the Contract Specialist whose number and address is shown at the bottom right corner of the questionnaire.

Thank you for your time and participation.

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

USAMRAA Form 74-R-E (FEB 2007)

PAST PERFORMANCE QUESTIONNAIRE

Your Name & Title yOUR Organizational Address

TEL NO.

FAX :

E-MAIL:

CONTRACTOR’S NAME & ADDRESS

TITLE OR DESCRIPTION OF REQUIREMENT:

CONTRACT NUMBER:

CONTRACT VALUE (INCLUDING OPTIONS):

CONTRACT TYPE:

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FIXED PRICE

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COST + FEE

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COMPETITIVE

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NON-COMPETITIVE

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SET-ASIDE

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SEALED BID

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NEGOTIATED

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SEALED BID

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NEGOTIATED

CONTRACT AWARD & COMPLETION DATE:

PAST PERFORMANCE ELEMENT
RATING
1
2
3
4
5
6
NA

1.

Contractor demonstrated a thorough understanding of technical requirements of the contract/task.

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Comments:

2.

Contractor anticipated/identified and resolved problems effectively.

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Comments:

3.

Contractor managed and directed resources (i.e. personnel, subcontractors, equipment, etc.) effectively.

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Comments:

4.

Contractor provided the necessary skilled personnel to perform the required work.

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Comments:

5.

Contractor retained the necessary skilled personnel and maintained a low turnover rate.

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Comments:

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

USAMRAA Form 74-R-E (FEB 2007)

PAST PERFORMANCE QUESTIONNAIRE

6.

Contractor met scheduled contract delivery dates.

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Comments:

7.

Contractor provided accurate, complete and high quality deliverables.

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Comments:

8.

Contractor complied with the terms of the contract.

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Comments:

9.

Contractor was diligent in forecasting and controlling contract cost.

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Comments:

10. I would recommend award to this contractor again.
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Comments:

1
0 – 25% of the time
Strongly Disagree
PLEASE RETURN COMPLETED RESPONSE TO: BRANDON ROEBUCK

U.S. Army Medical Research Acquisition Activity

ATTN: FCMR-AAA-MB1

820 Chandler Street

Fort Detrick, MD 21702-5014

E-MAIL: brandon.m.roebuck.civ@mail.mil

2
26 – 40% of the time
Disagree
3
41 – 55% of the time
Somewhat Disagree
4
56 – 70% of the time
Somewhat Agree
5
71 – 85% of the time
Agree
6
86 – 100% of the time
Strongly Agree

NA

No Knowledge of This Element

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

USAMRAA Form 74-R-E (FEB 2007)

File details come from the government source that posted it. Updated .