DRAFT_ATTACHMENT_4.pdf

DRAFT

ATTACHMENT 4

PAST PERFORMANCE ASSESSMENT QUESTIONNAIRE

NARRATIVE FORM

Solicitation W912DY-17-R-0014

CONTRACT INFORMATION (Contractor to complete #1-4)

1. Contractor Information:

Firm Name:

Address: Cage Code:

DUNS Number:

Phone Number: Email Address: Point of Contact:

Contact Phone Number:

2. Work Performed as:

Prime Contractor Subcontractor Joint Venture Other (Explain)

Percent of project work performed:

If subcontractor, who was the prime (Firm name/phone #):

3. Contract Information:

Contract Number:

Delivery/ Task Order Number (if applicable):

Contract Type: Firm Fixed-Price Cost Reimbursement Other (Please Specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy): Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable): Explain Differences:

4. Project Description:

Complexity of Work: High Med Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

Past Performance Risk Assessment Questionaire

CLIENT INFORMATION (Client to complete #5-8)

5. Client Information:

Name:

Title:

Phone Number:

Address:

6. Describe the client’s role in the project:

7. Date Questionnaire was completed:

8. Client’s Signature:

NOTE: USACE requests that the client complete the questionnaire and submit directly back to the offeror. The offeror will submit the completed questionnaire to USACE with its proposal, and may duplicate this questionnaire for future submissions on USACE solicitations. However, questionnaires may be submitted directly to USACE.

Please contact the offeror for USACE POC information. The Government reserves the right to verify any and all information on this form.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF

THE CONTRACTOR’S PERFORMANCE

Rating Definition Note

(O) 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.

An Outstanding rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/ Owner. A single benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been no significant weaknesses identified.

(G) 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.

A Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/ Owner. There should have been no significant weaknesses identified.

(A) Acceptable Performance meets contractual requirements.

Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

An Acceptable rating is appropriate when there were only minor problems, or major problems that the Contractor recovered from without impact to the contract. There should have been no significant weaknesses identified. Per DoD policy, a fundamental principle of assigned ratings is that Contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) 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.

A Marginal is appropriate when a significant event occurred that the Contractor had trouble overcoming which impacted the Government/ Owner.

(U) Unacceptable Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

An Unacceptable rating is appropriate when multiple significant events occurred that the Contractor had trouble overcoming and which impacted the Government/ Owner. A single problem, however, could be of such serious magnitude that it alone constitutes an Unsatisfactory rating.

(N) Not Applicable No information or did not apply to your contract. Rating will be neither positive nor negative.

**TO BE COMPLETED BY CLIENT**

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE

CONTRACTOR’S PERFORMANCE.

1. QUALITY:

a) Quality of technical data/ report preparation efforts O G A M U N

b) Ability to meet quality standards specified for technical performance O G A M U N

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance

O G A M U N

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

O G A M U N

2. SCHEDULE/ TIMELINESS OF PERFORMANCE: O G A M U N

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones (If liquidated damages were assessed or the schedule was not met, please address below.)

O G A M U N

b) Rate the Contractor’s use of available resources to accomplish tasks identified in the contract

O G A M U N

3. CUSTOMER SATISFACTION: O G A M U N

a) To what extent were the end users satisfied with the project? O G A M U N

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/ disputes; responsiveness to administrative reports, businesslike and communication)

O G A M U N

c) To what extent was the Contractor cooperative, businesslike, and concerned O G A M U N with the interests of the customer?

d) How well did the Contractor meet your system reliability expectations? O G A M U N

e) Overall customer satisfaction O G A M U N

4. MANAGEMENT/ PERSONNEL/ LABOR O G A M U N

a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force

O G A M U N

b) Ability to hire, apply, and retain a qualified workforce to this effort O G A M U N

c) Government Property Control O G A M U N

d) Knowledge/ expertise demonstrated by Contractor personnel O G A M U N

e) Utilization of Small Business concerns O G A M U N

f) Ability to simultaneously manage multiple projects with multiple disciplines O G A M U N

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

O G A M U N

h) Effectiveness of overall management (including ability to effectively lead, manage and control the program)

O G A M U N

5. COST/ FINANCIAL MANGEMENT O G A M U N

a) Ability to meet the terms and conditions within the contractually agreed price(s)?

O G A M U N

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefitted the client

O G A M U N

c) If this is/was a Government cost-type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate backup documentation, monthly status reports/ budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

O G A M U N

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

Yes No

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience and are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action, in Remarks section.

Yes No

f) Have there been any indications that the Contractor has financial problems? If yes, please explain in Remarks section.

Yes No

6. SAFETY/ SECURITY

a) To what extent was the Contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes:

following the user’s rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

O G A M U N

b) Contractor complied with all security requirements for the project and personnel security requirements.

O G A M U N

7. GENERAL O G A M U N

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues)

O G A M U N

b) Compliance with contractual terms/ provisions (explain if specific issues) O G A M U N

c) Was the contractor ever terminated for convenience or for default, issued a cure or show cause notice or have an option that was not exercised for performance reasons?

Yes No

d) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes No

e) Would you hire or work with this firm again? If no, please explain below. Yes No

f) In summary, provide an overall rating for the work performed by this O G A M U N

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

Contractor.