Appendix_D_(Revised).pdf

SOURCE SELECTION INFORMATION (SEE FAR 3.104)

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APPENDIX D

ENCLOSURE 1

PAST PERFORMANCE

DEPARTMENTOF THE ARMY

ARMY CONTRACTING COMMAND

REGIONAL CONTRACTINGOFFICE– ALASKA

1064 APPLESTREET, PO BOX 35510

FORTWAINWRIGHT, AK9973-0510

19 Mar 2018

CCEC-PAW

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W912D0-19-R-0002

Dear Sir/Ma’am:

The Regional Contracting Office-Alaska is currently conducting a competitive Small Business 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) 561720. 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 Regional Contracting Office-Alaska, PO Box 35510, Fort Wainwright, Alaska 99703 no later than 28 Mar 19 (FGA/MDA).

Your questionnaire may be submitted electronically to rhonda.m.richardson.civ@mail.mil and john.r.quarles.civ@mail.mil.

Your cooperation is greatly appreciated. Questions may be directed to requesting entity’s designated POC as indicated in the questionnaire Part I Block B, or by contacting the RCO-AK POCs: Rhonda Richardson 907-353-7300 or John Quarles 907- 353-2368.

Sincerely, JOHN R. QUARLES

Contracting Officer

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ENCLOSURE 2

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor: Contract No.:

Subcontract No. (if applicable):

POC: Title:

(Name) (E.G. PCO/ACO/TM)

(Agency, 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.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

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)

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:

Name:

Title:

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

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Date:

Telephone Number:

E-mail Address:

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

Acceptable Unacceptable (Explanation must be provided in Comments field below)

Comments:

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables.

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

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

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

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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:

Title:

Date:

Telephone Number

PART III. RETURN INFORMATION

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

Thank you for your assistance.

Signature Date

Typed or Printed Name

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

H. Respondent Identification. Please provide the following information:

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ENCLOSURE 3

TELEPHONE INTERVIEW QUESTIONNAIRE FORM

Contractor: Contract No.:

Subcontract No. (if applicable):

POC: Title:

(Name) (E.G. PCO/ACO/TM)

(Agency, Telephone No., E-mail & Facsimile No.)

If conducting a telephone interview:

“Hello, I am . I am calling in reference to Contract with a company called . My questions will pertain to the contractor’s record of past, which is defined as 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. A summary of this discussion may be sent to you for your records. The following adjectival ratings shall be used in your response.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

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)

Contractor/Company Name/Division:

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:

Title:

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

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Date:

Telephone Number:

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

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

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables.

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

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

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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:

Title:

Date:

Telephone Number

Record of Interview: (to be filled out by PPT member)

( ) Discussed recentness and relevance of information ( ) Read summary to person contacted Date:

( ) Sent copy to person contacted Date:

PPT Member Signature Typed or Printed Name

Telephone Fax

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

H. Respondent Identification. Please provide the following information:

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ENCLOSURE 4

TELEPHONE INTERVIEW REPORT FORWARDING MEMORANDUM

Contracting Office

MEMORANDUM FOR

SUBJECT: Telephone Interview Report

1. Enclosed is a summary of your telephone conversation, (date), with a member of a Past Performance Team at this Command.

2. It is requested that you review and verify the accuracy of this report and e-mail or fax it to us by (date). It is extremely important that you respond by this date so Army readiness will not be compromised. If we do not hear from you by the day indicated above, we will consider the summary of the discussion official.

3. We would like to thank you in advance for your time and assistance regarding this acquisition. If you have any questions or comments, you may address them to the Contract Specialist at 907-353-7126 or email to the following emails, rhonda.m.richardson4.civ@mail.mil, and john.r.quarles.civ@mail.mil.

Encl (1)

John R. Quarles Contracting Officer