W9124N16R0002-Attachment-8.doc

ATTACHMENT 8

PAST PERFORMANCE QUESTIONNAIRE

When filled in this document is source selection sensitive information iaw FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor/Company Name: ________________________________________________________

B. Cage Code: _______________________ DUNS Number: _______________________________ C. Contract number: _______________________ Contract Title:______________________________ D. Contract type (Firm-Fixed Price, Cost Reimbursement, etc: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract value: $____________________________

H. Current/final contract value: $_______________________________

I. Reasons for differences between initial contract cost and final contract costs:

J. Description of service provided: ______________________________________________________________

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name receiving services: _______________________________________________________________________________________

B. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: CUSTOMER’S IDENTIFICATION

A. Customer’s name: ______________________________________________________________________________________

B. Customer’s title: ______________________________________________________________________________________

C. Customer’s phone/email address: ______________________________________________________________________________________

D. Number of years customer observed contractor’s performance/ surveilled contractor’s performance or received contractor’s support services under subject contract:

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE

PERFORMANCE LEVEL

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

US

UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

NA

NOT APPLICABLE - Unable to provide a score.

Customer would have no reservations in awarding another contract to the contractor.

Commitment to Customer Satisfaction and Business-like Concerns for its Customers Interest.

Contractor was reasonable and cooperated to resolve problems, attended meetings as needed, and maintained communication with the Government to keep required services on schedule.

Contractor’s Work Staff, including Subcontractors (adequately trained; possess necessary skills; perform effectively in accordance with contract terms; etc).

Contractor provided experience/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements

Contractor’s overall management and responsiveness.

Contractor ensured the project manager had sufficient authority to make decisions and take actions during contract performance.

Ability to retain a qualified workforce on this effort to maintain continuity of services.

Timely contract start-up (acquired required licenses, training, administrative clearances, equipment, etc.) and was prepared to start performance by contract start date.

Contractor ability to smoothly transition resources and personnel.

Contractor provided effective quality control and/or inspection procedures to meet contract requirements.

Timely performance of administrative actions (e.g. submission of required reports, records, and other data submissions)

Contractor’s Quality Control System (ability to identify and correct deficiencies in a timely manner and pursuant to their quality control plan)

Timeliness of Performance for Services

Timeliness/effectiveness of contract problem resolution without extensive customer guidance

Contractor’s ability to manage its workforce during fluctuating workloads.

Contractor’s ability to meet emergency, urgent or routine timelines.

Responsiveness to contract changes

Contractor’s ability to meet or exceed small business and small disadvantaged business goals set forth in the approved subcontracting plan

Government Furnished Property Administration (If applicable)

1. Please discuss each area for which you provided a rating of M (Marginal) or US (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

2. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes____ Default____ Convenience____ Pending Terminations____ No ____

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

Evaluator’s Signature

Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to the following e-mail address with the subject heading W9124N16R0002-Past Performance Questionnaire:

Amber.k.vanhoozer.civ@mail.mil and martha.s.livsey.civ@mail.mil