Attachment3.pdf

Source Selection Information – See FAR 2.101 and 3.104

PAST PERFORMANCE QUESTIONNAIRE

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does.

Please return the completed Questionnaire No later than 4 May, 2016 via e-mail to the following addresses: richard.s.button2.mil@mail.mil and shariyun.k.lawson.civ@mail.mil.

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:

FAX Number:

Address:

E-mail Address:

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

Excellent (Explanation must be provided in Comments field below) Good Adequate Marginal Poor, did not Meet Contractual Requirements (Explanation must be provided in

Comments field below) Unknown

Comments:

A. Quality. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship under Government contracts and private sector contracts.

mailto:stefani.santos.civ@mail.mil

Adequate Marginal Poor, did not Meet Contractual Requirements (Explanation must be provided in

Comments field below) Unknown

Comments:

Adequate Marginal Poor, did not Meet Contractual Requirements (Explanation must be provided in

Comments field below) Unknown

Comments:

Excellent (Explanation must be provided in Comments field below) Good Adequate Marginal Poor, did not Meet Contractual Requirements (Explanation must be provided in

Comments field below)

Adequate Marginal

B. Schedule. Timeliness of Performance for Services and Product Deliverables, including the Administrative Aspects of Performance.

E. Overall Satisfaction.

C. Business Relations: Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest. Integration and coordination of activity needed to execute the contract; the timeliness, completeness, and quality of problem identification, and corrective action plans; proposal/modification submittals; the contractor’s history of reasonable and cooperative behavior.

D. Key Personnel: Effectiveness of Project Management (to include use and control of subcontractors), selecting and retaining key Management Personnel (i.e. hire and staff qualified personnel, the frequency turnover rate of key personnel, training replacements).

Poor, did not Meet Contractual Requirements (Explanation must be provided in Comments field below)

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:

Organization:

Name:

Title:

Date:

Telephone Number Address:

Fax Number:

E-mail Address:

F. General Comments. Provide any other relevant performance information.

G. Other Information Sources. Please provide the following information:

H. Respondent Identification. Please provide the following information: