EPCARTS_Attachment_06_Past_Perf_Questionnaire.pdf

Attachment 6: Past Performance Questionnaire

REPLY TO

ATTENTION OF

DEPARTMENT OF THE ARMY

ARMY CONTRACTING COMMAND - REDSTONE

BUILDING 5303, MARTIN ROAD

REDSTONE ARSENAL, ALABAMA 35895-5000

Directorate B, Contracting & Acquisition Management Office

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W9113M-17-R-0001

Dear Sir or Madam:

This letter, as well as the attached questionnaire, has been forwarded to you by the firm identified in the attached Past Performance Questionnaire. This firm intends to submit a proposal as either a prime contractor or a major subcontractor in response to the subject solicitation, which was issued by the U.S.

Army Contracting Command – Redstone on behalf of a contractual requirement for the U.S Army Space & Missile Defense Command/Army Forces Strategic Command (USASMDC/ARSTRAT).

It is requested that the questionnaire be completed for the contract identified therein. It is stressed that this questionnaire must be completed by the Government employee having technical or contractual cognizance over the cited contract, and that individual sign the questionnaire as a validation of the assessment. It is further requested that the questionnaire be returned via e-mail to the Government point of contact (POC) listed below within fifteen (15) days from receipt of this letter. DO NOT RETURN

YOUR RESPONSE TO THE CONTRACTOR THAT FORWARDED THIS QUESTIONNAIRE

TO YOU.

GOVERNMENT POC: Jessica N. Ely jessica.n.ely3.civ@mail.mil US Army SMDC/ARSTRAT

ATTN: CAMO/ Ms. Jessica N. Ely P.O. Box 1500 Huntsville, AL 35807-3801

A member of our Performance Risk Assessment Group may be in contact with you regarding your response should it become necessary. In the event that your response contains derogatory or superlatively positive responses/comments regarding the contractor’s performance, you are requested to submit available documentation supporting these assessments. Your submittal of such documentation will hopefully eliminate post-response inquiries.

If you have any questions about this request or the overall past performance process, please contact Ms. Jessica N. Ely at jessica.n.ely3.civ@mail.mil or (256) 955-5974.

Sincerely, //s// Jessica N. Ely Contracting Officer mailto:jessica.n.ely3.civ@mail.mil mailto:jessica.n.ely3.civ@mail.mil

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION (SEE FAR 3.104)

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor:____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________ POC:________________________ Title:________________________ (Name) (E.G. PCO/ACO/TM) (Organization, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor’s record of past (within the past five 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).

� 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:

C. Timeliness of Performance for Services and Product Deliverables.

� 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:

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

� 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:

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

� 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:

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:

Name:

Title:

Date:

Telephone