W91ZLK-13-R-0005_APPENDIX_H.pdf

APPENDIX H: PAST PERFORMANCE QUESTIONNAIRE

1. INSTRUCTIONS TO THE OFFEROR FOR HANDLING THIS PAST

PERFORMANCE QUESTIONNAIRE

Prepare and send a Past Performance Questionnaire package to at least three (3) references. These references can be for the prime contractor and major subcontractors proposed for the effort. For Government contracts, send to a Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for Government contracts. It is the offeror’s responsibility to follow-up with the references to ensure they send in questionnaires. The questionnaire package should contain the following: cover letter (see example), and the Past Performance Questionnaire.

2. INSTRUCTIONS TO THE REFERENCE FOR COMPLETING THIS PAST

PERFORMANCE QUESTIONNAIRE

Handwritten completion of this questionnaire is acceptable, if legible.

Please include evaluation of contractor's performance based solely on the performance for which the contractor was/is liable. Do not let factors beyond the control of the contractor which have resulted in performance delays or other problems bias the evaluation of the contractor's performance.

The following is a definition of the scoring system used:

Exceptional: Performance meets contractual requirements and exceeds many to the Owner’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Owner’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory: Performance meets contractual requirements. The contractual performance of the area being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element being assessed evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

In completing the questionnaire please circle a letter corresponding to your rating, or "N/A" if you are unable to provide an evaluation for any area.

Please provide clear and concise narrative explanations (both positive and negative) for your answers. This is especially important for any rating above or below “satisfactory”. If more space is needed than is provided, you may use the back of the questionnaire or attach additional sheets.

SAMPLE TRANSMITTAL LETTER

(Company Letterhead)

Date: _________________

To: ______________________________________

We have listed you as a reference for work we have performed for your firm as noted on the attached questionnaire. Our firm intends to submit a proposal under RFQ W91ZLK- 13-R-0005 for analytical, engineering, technical, and management support services. In accordance with Government regulations, they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments.

Please send your completed questionnaire to the following address to arrive NOT LATER THAN *date, the date set for receipt of proposals. Do NOT return them to our company.

Army Contracting Command-Aberdeen Proving Ground ATTN: CCAP-SCI (D. MacIntyre) 4118 Susquehanna Avenue

APG, MD 21005-3013

Email: david.a.macintyre.civ@mail.mil Phone: (410) 278-4693

Questionnaires may be mailed, or e-mailed to the above address.

If you have questions regarding the attached questionnaire, or require assistance, please contact the individual named above. Thank you for your assistance.

Signature and Title mailto:david.a.macintyre.civ@mail.mil

PAST PERFORMANCE QUESTIONNAIRE

(To be completed and returned by the “Reference”)

I. CONTRACTOR/CONTRACT IDENTIFICATION.

A. Contractor (Company/Division):

B. Contract Number/Identification:

C. Contract Title (Brief Description of Work and Location):

D. Contract Type: Fixed-Price, Cost-Reimbursement;

E. Owner: Federal / State / Local Government or Private/Commercial

F. Period of Performance:

G. Original Dollar Amount of Contract:

H. Number of Modifications:

I. Dollar Amount at Completion (or current amount, if not complete):

II. PAST PERFORMANCE/QUALITY EVALUATION:

1. Quality of Product or Service - Assess the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards):

___ Outstanding ___ Very Good ___ Satistactory ___ Marginal ___ Unsatisfactory ___ N/A

Comments:

2. Schedule - Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, administrative requirements (e.g., efforts that contribute to or effect the schedule variance):

___ Outstanding ___ Very Good ___ Satistactory ___ Marginal ___ Unsatisfactory

3. Cost Control (Not applicable if the referenced contract was firm fixed price) Assess the contractor’s effectiveness in forecasting, managing and controlling contract cost:

___ Outstanding ___ Very Good ___ Satistactory ___ Marginal ___ Unsatisfactory

4. Business Relationships - Assess the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective actions plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and the timely award and management of subcontracts. Additionally, please comment as to whether the contractor met small/small disadvantaged and women-owned business participation goals:

___ Outstanding ___ Very Good ___ Satistactory ___ Marginal ___ Unsatisfactory

5. Technical Competence - Assess the knowledge of, and skill in the exercise of, practices required for successful completion of the contract:

___ Outstanding ___ Very Good ___ Satistactory ___ Marginal ___ Unsatisfactory

6. If you had a choice, would you use this company again?

___ Yes ___ No (Explain)

7. Other contacts who may be able to furnish past performance information

(TO BE COMPLETED AND RETURNED BY THE REFERENCE.)

***Personal Information WILL NOT be released outside of the Government***

A. Name of Evaluator:

B. Title:

C. Telephone Number:

D. Company/Organization:

E. Position held in reference to the contract (Technical Inspector, Contract Administrator, ETC.):

F. Length of involvement in contract:

G. Was the contractor given the opportunity to respond to all adverse past performance information?

___ Yes ___ No ___ Not Applicable ___ Unknown

Explain:

H. Date questionnaire completed/information provided:

I. (If the information was submitted in writing) Signature of the respondent:

J. (if the information was obtained telephonically) Signature(s) of the Government representative(s) do documenting the phone call: