A07_Attachment_10_Past_Perforamce_Questionnaire_W91CRB-16-R-0010.pdf

PAST PERFORMANCE ASSESSMENT QUESTIONNAIRE W91CRB-16-R-0010

Please provide your candid response to the following questions. The information that you provide will be used in the potential award of a defense contract. Therefore, it is important that your information be as factual and accurate as possible. If you do not have the appropriate knowledge of or experience with the company in question, please forward this questionnaire to the person who does. Please return within three (3) days. Thank you.

PART I - Contract Identification (To be completed by the Offeror)

Contractor/Company_______________________________________ Name/Division_______________________________________ Address_______________________________________ Identification of Offeror’s Representative Name: _______________________________________ Title: _______________________________________ Telephone:_____________________________________________________________________ Number:

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

Contract Number (include Deliver Order number if applicable): Program Identification/Title:_______________________________________ Brief Description of product/services provided:

Contract type (Firm-Fixed-Price, Cost-Plus-Fixed-Fee, Cost-Plus-Incentive-Fee, Other):

Period of Performance: Initial Contract award amount: Final or projected contract amount: Has this contract been partially or completely terminated for default or convenience? If so, why?

PART II - Respondent Identification (To be completed by respondent) Please provide the following information:

Name:

Title:

Organization or Company:

Address: E-mail Address: Telephone Number:

Fax Number: Respondent’s role in contract: Respondent’s length of involvement:

Date questionnaire completed:

PART III – EVALUATION (To be completed by respondent) EVALUATION CRITERIA

(E) Excellent - A significant majority of the sources of information are consistently firm in stating that the Offeror’s performance was superior and that they would unhesitatingly do business with the Offeror again. Complaints are negligible or unfounded.

(G) Good - Most sources of information state that the Offeror’s performance was good, better than average, etc., and that they would willingly do business with the Offeror again. Complaints, though perhaps well-founded, are few and relatively minor.

(M) Marginal - Many sources of information make unfavorable reports about the Offeror’s performance and either express serious doubts about doing business with the Offeror again or state that they would refuse to do so. However, there are some favorable reports, and some sources of information indicate that they would do business with the Offeror again.

(U) Unacceptable - A significant majority of sources of information are consistently firm in stating that the Offeror’s performance was entirely unsatisfactory and that they would not do business with the Offeror again under any circumstances. Customer complaints are substantial or numerous and are well-founded.

N/A - Not applicable. Respondent has no personal knowledge.

PLEASE UNDERLINE/CIRCLE THE APPROPRIATE RATING FOR QUESTIONS 1-9,

USING THE SPACE BELOW EACH QUESTION FOR DETAILS/COMMENTS

1. The referenced Contractor’s accessibility and responsiveness to customer questions and concerns

E G M U N/A

2. The qualifications and ability of the Contractor’s personnel to meet the contractual requirements over the life of the contract.

3. The referenced Contractor’s conformance with and understanding of the tasks detailed in the

Statement of Work, Performance Work Statement and/or Delivery/Task Orders.

4. The referenced Contractor’s ability to complete tasks with minimum customer oversight.

5. The referenced Contractor’s ability to complete tasks correctly the first time.

6. The ability of the referenced Contractor to hire and retain a stable workforce.

7. The referenced Contractor’s ability to resolve problems with minimum disruptions to operations.

8. The referenced Contractor’s quality of studies and analyses

9. The referenced Contractor’s quality of data preparation efforts.

PLEASE PROVIDE SUBJECTIVE RESPONSES FOR THE FOLLOWING

10. Discuss any response (above) for which you indicated a response of “M” or less.

FOR OFFICIAL USE ONLY

SOURCE SELECTION SENSITIVE

11. With respect to overall technical performance, would you recommend this contractor for similar government contracts? If no, why not?

12. Have you experienced special or unique problems with the referenced Contractor that we should be aware of in making a decision?

FOR OFFICIAL USE ONLY

SOURCE SELECTION SENSITIVE

13. Was this Contractor cooperative in dealing with the Government (circle one)? YES NO

If no, please explain.

14. Was a show-cause letter or cure notice ever issued on this contract? If yes, please describe the circumstances and resolution.

15. Please provide any additional comments concerning the Contractor’s performance.

16. If you know of anyone else who might have relevant information concerning the Contractor’s past performance, please complete the following:

Name: Organization/Company: Telephone Number: Fax Number:

E-mail Address:

THANK YOU FOR YOUR ASSISTANCE