A07_Perform_Risk_Questionaire_Attach_3.docx

W91CRB-17-R-0003 Attachment 3

PAST PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE

You have been identified as a Point of Contact (POC) by the contractor identified below as having knowledge of or experience with the contractor’s performance. The contractor has indicated intent to submit a proposal to the ongoing Office of Small Business Programs Operational Support Services, Solicitation #W91CRB-17-R-0003. Your candid responses to this questionnaire will be of assistance in the source selection process. Therefore, it is important that the information you provide 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 a person who does.

Please return the completed Questionnaire no later than 12:00PM EST 10 February 2017.

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:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) A--Compliance of products, services, documents, and related deliverables to specification requirements and standards of good workmanship

· Exceeds Contractual Requirements (Provide explanation in Comments field below.)

· Meets Contractual Requirements

· Failed to Meet Contractual Requirements (Provide explanation in Comments field below.)

Comments:

B--Effectiveness of project management (to include use and control of subcontractors).

· Exceptional (Provide explanation in Comments field below.)

· Satisfactory

· Unsatisfactory (Provide explanation in Comments field below.)

Comments:

C--Timeliness of performance for services and product deliverables, including the administrative aspects of performance.

· Exceeds Contractual Requirements (Provide explanation in Comments field below.)

· Meets Contractual Requirements

· Failed to Meet Contractual Requirements (Provide explanation in Comments field below.)

Comments:

D--Effectiveness in forecasting and controlling project cost.

· Exceptional (Provide explanation in Comments field below.)

· Satisfactory

· Unsatisfactory (Provide explanation in Comments field below.)

Comments:

E--Commitment to customer satisfaction and business-like concern for its customers’ interest.

· Exceptional (Provide explanation in Comments field below.)

· Satisfactory

· Unsatisfactory (Provide explanation in Comments field below.)

Comments:

F--Overall satisfaction.

· Extremely Satisfactory (Provide explanation in Comments field below.)

· Satisfactory

· Unsatisfactory (Provide explanation in Comments field below.)

Comments:

G--General comments. (Provide any other relevant performance information.)

H--Other information sources. Please provide the following information:

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:

I--Respondent identification. Please provide the following information on yourself:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return your completed Questionnaire via e-mail directly to the Contracting Officer (KO) and Contract Specialist (KS) listed below:

romona.f.kelly.civ@mail.mil Contracting Officer jade.c.gaston.civ@mail.mil Contract Specialist

Thank you for your assistance!