Attachment 3: Past Performance Report Form docx safe

Solicitation N0018924XXXX

PAST PERFORMANCE REPORT FORM

Complete and return NLT the due date of the solicitation to: Fleet Logistics Center Norfolk (FLCN) Contracting Department Attn: First and Last Name, Code
Phone:
Email:
On behalf of:
Company’s Name:
POC, Title/Position:
Email Address:
Contract/Purchase Order No.:
Contract Amount: $
Contract Type:
Period of Performance: Click or tap to enter a date. – Click or tap to enter a date. Business Address:

Phone Number:

NOTE:

DO NOT RETURN TO THE CONTRACTOR WHO ORIGINATED THIS

REQUEST

Source Selection Information – See FAR 2.101 and 3.104

Solicitation N0018924XXXX

The completion of this questionnaire is requested from your agency/company in order for the U.S. Naval Supply System (NAVSUP) Fleet Logistics Center Norfolk (FLCN) to evaluate the aforementioned contractor’s past performance on previous contracts and efforts as it relates to the probability of successful accomplishment of the work required by the Government, relative to the award of a contract resulting from the solicitation. Completed by:
Command/Company’s Name:
POC, Title/Position:
Email Address
Business Address:

Phone Number:

Quality:
1. Recruiting: The offeror’s demonstrated ability to recruit personnel with the skill sets, qualifications/certifications, experience and security clearance required of the contract. Provide additional comments if necessary.
Click or tap here to enter text.

2. Retention: The offeror’s demonstrated ability to maintain a stable workforce. Click or tap here to enter text.

3. Meeting Contract Requirements: The offeror’s demonstrated history of delivering products and services that met or exceeded the requirements of the contract. a. How would you describe your level of customer satisfaction? Click or tap here to enter text.

b. Were there instances of rework and/or deficiency reports? (If yes, explain) Click or tap here to enter text.

Source Selection Information – See FAR 2.101 and 3.104

Solicitation N0018924XXXX

c. Did the contractor engage in effective and/or innovative work applications that were beneficial to the Government?
Click or tap here to enter text.

Timeliness:
1. Did the Contractor meet/comply with performance schedules? Click or tap here to enter text.

a. Rate the timeliness of submission of requested information, reports and invoicing. Click or tap here to enter text.

Responsiveness:
1. Describe the offeror’s demonstrated ability to respond to customer concerns Click or tap here to enter text.