Atch_2_Past_Performance_Questionnaire.docx

REPLY TO

ATTENTION OF

DEPARTMENT OF THE ARMY

413TH CONTRACTING SUPPORT BRIGADE

RCO HAWAII, 724 SANTOS DUMONT AVENUE

BUILDING 108, 3rd FL (WAAF)

SCHOFIELD BARRACKS, HAWAII 96857

2 Sep 16

Construction, Supplies and Services Division (CSSD)

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W912CN-16-R-0006

Dear Sir/Ma’am:

The Regional Contracting Office – Hawaii (RCO-HI) is currently conducting a competitive source selection to evaluate Offerors on subject RFP. As part of this evaluation, we have requested that the Offerors provide information about their past performance on same or similar federal, state or local government or commercial contracts as compared to North American Industry Classification System (NAICS) 561730. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the 413th Contracting Support Brigade, Regional Contracting Office-Hawaii, 742 Santos Dumont Avenue, Bldg. 108, 3rd Floor, Schofield Barracks, HI 96857, no later than ten (10) days after receipt of request or 22 Sep 16, 1000 AM Hawaii Standard Time (HST), whichever occurs first. Your completed questionnaire may be submitted electronically to annabelle.f.miller.civ@mail.mil or irvin.g.bonus.civ@mail.mil.

Your cooperation is greatly appreciated. Questions may be directed via e-mail to the contract specialist, Annabelle F. Miller or the undersigned at the above email addresses.

Sincerely,

W912CN-16-R-0006

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

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 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:

Contract Amount (include all performance periods):

Period of Performance (include all option periods):

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. Quality of Service: A pattern of successful completion of tasks of good quality conforming to the PWS requirements.

· 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. Schedule/Timeliness of Performance: A pattern of submitting deliverables/completing tasks that are timely.

· Acceptable

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

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

C. Business Relations: A pattern of cooperativeness and teamwork with the Government at all levels (task managers, contracting officers, auditors, etc.).

· Acceptable

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

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

D. Management of Personnel: A pattern of effective hiring and retention practices.

· Acceptable

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

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

E. General Comments: Provide any other relevant performance information.

F. 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:

G. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer and the Contract Specialist identified in the cover letter.

Thank you for your assistance.

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