Attachment_1_Past_Performance_Questionnaire.pdf

6 September 2019

CCMI-CSH-BE

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W91QV119R0156

Dear Sir/Ma’am;

The Mission Installation Contracting Command Fort Belvoir (MICC-FB) is currently conducting a competitive proposal review 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) 238290. 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 MICC-FB, 9410 Jackson Loop, Bldg.

1425, Fort Belvoir VA 22060, no later than 5 days after receipt of request or NLT 3:00pm ET on 20 September 2019, whichever occurs first. Your questionnaire may be submitted electronically to Stacy Alleyne at stacy.n.alleyne.ctr@mail.mil and MAJ Keisha Teixeira at keisha.a.teixeira.mil@mail.mil.

Your cooperation is greatly appreciated. Questions may be directed to stacy.n.alleyne.ctr@mail.mil or 703-806-2166.

Sincerely, KEISHA A. TEIXEIRA

MAJ, AG

Contracting Officer

DEPARTMENT OF THE ARMY

MISSION INSTALLATION CONTRACTING COMMAND

9410 JACKSON LOOP, BUILDING 1425

FORT BELVOIR, VIRGINIA 22060

REPLY TO

ATTENTION OF:

mailto:stacy.n.alleyne.ctr@mail.mil mailto:keisha.a.teixeira.mil@mail.mil

Attachment 1

W91QV119R0156

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)

Please provide your candid responses. The information that you provide will be used in the awarding of 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. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within 5 days or NLT 3:00pm ET on 20 September 2019.

Adjectival Rating Definitions:

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.

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.

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

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.

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)

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

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

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

Acceptable

C. Timeliness of Performance for Services and Product Deliverables.

Acceptable

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

Acceptable

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

F. 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:

G. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the points of contact identified in the cover letter.

Thank you for your assistance.