PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

The information that you provide will be used as part of the evaluation to award 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. Offerors are to complete Part I of this Questionnaire and forward the Questionnaire to the offerors’ representatives. Offerors are to carbon copy USPFO-DC of their submission to the offerors’ representatives at the following to e-mail address: mardela.scott.mil@mail.mil and ng.dc.dcarng.mbx.pc-requirement-request@mail.mil

NOTE: Offerors are to provide a separate questionnaire for each relevant mission/business critical/comparable/similar project.

PART I. (To be completed by the offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Government Point of Contact:

Government Title:

Government Telephone Number:

Government FAX Number:

Government E-mail Address:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the Contractor name cited above):

Contract Award Date:

Forecasted and Actual Contract Completion Date:

Forecasted and Actual Contract Award Amount:

Nature of the Contractual Effort or Items Purchased:

Contract Subcontracting % Goals for FAR Part 19 participants (Small Business, Small Disadvantaged Business, etc.) and Actual Contract % Subcontracted

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE COMPLETING PART I OF THIS

QUESTIONNAIRE

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address

PART II EVALUATION (To be completed by the point of contact cited in Part I, Section A - CONTRACT IDENTIFICATION – Government Respondent)

NOTE: If you, as the point of contact, do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who may have the information and notify CONTRACT SPECIALIST by e-mail at mardela.scott.mil@mail.mil and ng.dc.dcarng.mbx.pc-requirement-request@mail.mil attention:

CONTRACT SPECIALIST name and contact information.

Please provide your candid responses.

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

Exceeds Contractual Requirements (Explanation must be provided in Comments field below) Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

Comments:

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

Exceptional (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

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

Exceeds Contractual Requirements (Explanation must be provided in Comments field below) Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below)

Comments:

D. Effectiveness in Forecasting and Managing Project Cost/Price.

Exceptional (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

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

Exceptional (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

F. Commitment to responsibilities under FAR 52.219-8 -- Utilization of Small Business Concerns.

Highly Satisfied (Explanation must be provided in Comments field below) Satisfied

Not Satisfied (Explanation must be provided in Comments field below) Comments:

G. Commitment to responsibilities under FAR 52.219-9 – Small Business Subcontracting Plan.

Satisfied

H. Overall Satisfaction.

Satisfied

I. Given this Contractor’s performance, would you choose to contract with them again?

Yes No

General Comments. Provide any other relevant performance information.

J. Are you aware of other relevant past efforts by this company?

Yes No

If yes, please provide the name and telephone number of a point of contact:

Respondent Identification. - Please provide the following information:

Government Organization:

Address: Name:

Government Title: Date:

Telephone Number: Fax Number:

E-mail Address:

PART III RETURN INFORMATION

Please complete Part II of this Questionnaire and return the entire Questionnaire via e-mail to at mardela.scott.mil@mail.mil and ng.dc.dcarng.mbx.pc-requirement-request@mail.mil by the closing date of this RFQ.